PMID- 32251121
OWN - NLM
STAT- MEDLINE
DCOM- 20201023
LR  - 20210123
IS  - 1537-453X (Electronic)
IS  - 0277-3732 (Linking)
VI  - 43
IP  - 7
DP  - 2020 Jul
TI  - Combination Therapy for Metastatic Renal Cell Carcinoma: A Systematic Review and 
      Network Meta-analysis.
PG  - 477-483
LID - 10.1097/COC.0000000000000695 [doi]
AB  - INTRODUCTION: Randomized clinical trials have shown combination therapy to be 
      superior in progression-free survival (PFS) rates when compared with sunitinib 
      alone. However, there have been no direct comparisons among the combination 
      strategies making it unclear as to which may be the preferred option. We 
      performed a network meta-analysis of the combination therapy (immune checkpoint 
      inhibitor plus axitinib or bevacizumab) used in metastatic renal cell carcinoma 
      (mRCC) and provided a rank order preference based on PFS, and adverse events 
      (AEs). MATERIALS AND METHODS: A systematic search on the treatment of mRCC using 
      combination therapy till July 2019 was done. Studies reporting on combination 
      therapies with immune checkpoint inhibitor plus axitinib or bevacizumab for mRCC 
      were selected. Frequentist method was used for rank order generation. RESULTS: A 
      total of 3 studies consisting of 2672 patients were selected. All combination 
      therapies demonstrated improved PFS when compared with sunitinib alone. The rank 
      order for PFS showed combination of pembrolizumab plus axitinib had the highest 
      probability of favorability followed by avelumab plus axitinib and atezolizumab 
      plus bevacizumab (surface under the cumulative ranking 0.9, 0.7, and 0.4, 
      respectively). For AEs, pembrolizumab plus axitinib had the least AEs >/=grade 3, 
      followed by avelumab plus axitinib and atezolizumab plus bevacizumab (surface 
      under the cumulative ranking 0, 0.5, 1.0). CONCLUSIONS: This network 
      meta-analysis demonstrates that combination of pembrolizumab plus axitinib may be 
      the preferred option based on efficacy and side effect profile compared with 
      avelumab plus axitinib or atezolizumab plus bevacizumab. However, all the 3 
      combination strategies were superior to sunitinib alone in improving PFS in 
      patients with mRCC.
FAU - Alam, Muhammad U
AU  - Alam MU
AD  - Department of Urology.
FAU - Jazayeri, Seyed B
AU  - Jazayeri SB
AD  - Department of Urology.
FAU - Gautam, Shiva
AU  - Gautam S
AD  - Department of Urology.
AD  - Center for Data Solutions, University of Florida, Jacksonville, FL.
FAU - Norez, Daniel
AU  - Norez D
AD  - Department of Urology.
AD  - Center for Data Solutions, University of Florida, Jacksonville, FL.
FAU - Kumar, Jatinder
AU  - Kumar J
AD  - Department of Urology.
FAU - Tanneru, Karthik
AU  - Tanneru K
AD  - Department of Urology.
FAU - Nguyen, Sabine
AU  - Nguyen S
AD  - Department of Urology.
FAU - Costa, Joseph
AU  - Costa J
AD  - Department of Urology.
FAU - Bandyk, Mark
AU  - Bandyk M
AD  - Department of Urology.
FAU - Ganapathi, Hariharan P
AU  - Ganapathi HP
AD  - Department of Urology.
FAU - Koochekpour, Shahriar
AU  - Koochekpour S
AD  - Department of Urology.
FAU - Balaji, K C
AU  - Balaji KC
AD  - Department of Urology.
LA  - eng
PT  - Journal Article
PT  - Meta-Analysis
PT  - Systematic Review
PL  - United States
TA  - Am J Clin Oncol
JT  - American journal of clinical oncology
JID - 8207754
RN  - 0 (Antibodies, Monoclonal, Humanized)
RN  - 0 (Antineoplastic Agents, Immunological)
RN  - 2S9ZZM9Q9V (Bevacizumab)
RN  - 52CMI0WC3Y (atezolizumab)
RN  - C9LVQ0YUXG (Axitinib)
RN  - DPT0O3T46P (pembrolizumab)
RN  - KXG2PJ551I (avelumab)
RN  - V99T50803M (Sunitinib)
SB  - IM
MH  - Antibodies, Monoclonal, Humanized/administration & dosage
MH  - Antineoplastic Agents, Immunological/administration & dosage
MH  - Antineoplastic Combined Chemotherapy Protocols/*therapeutic use
MH  - Axitinib/administration & dosage
MH  - Bevacizumab/administration & dosage
MH  - Carcinoma, Renal Cell/*drug therapy
MH  - Humans
MH  - Kidney Neoplasms/*drug therapy
MH  - Network Meta-Analysis
MH  - Sunitinib/administration & dosage
EDAT- 2020/04/07 06:00
MHDA- 2020/10/24 06:00
CRDT- 2020/04/07 06:00
PHST- 2020/04/07 06:00 [pubmed]
PHST- 2020/10/24 06:00 [medline]
PHST- 2020/04/07 06:00 [entrez]
AID - 00000421-202007000-00004 [pii]
AID - 10.1097/COC.0000000000000695 [doi]
PST - ppublish
SO  - Am J Clin Oncol. 2020 Jul;43(7):477-483. doi: 10.1097/COC.0000000000000695.