PMID- 34546767
OWN - NLM
STAT- MEDLINE
DCOM- 20220120
LR  - 20220120
IS  - 1527-3792 (Electronic)
IS  - 0022-5347 (Linking)
VI  - 207
IP  - 1
DP  - 2022 Jan
TI  - Clinical Outcomes and Adverse Events after First-Line Treatment in Metastatic 
      Renal Cell Carcinoma: A Systematic Review and Network Meta-Analysis.
PG  - 16-24
LID - 10.1097/JU.0000000000002252 [doi]
AB  - PURPOSE: Four recent first-line clinical trials leveraging immune-oncology agents 
      demonstrated an overall survival (OS) benefit relative to sunitinib. We aimed to 
      provide formal comparisons among immune-oncology combinations in terms of OS, 
      progression-free survival (PFS), objective response rates and treatment-related 
      adverse events (AEs). MATERIALS AND METHODS: PubMed(R) database was searched for 
      studies indexed from January 1, 2016 through March 6, 2021. Only phase III 
      randomized clinical trials with proven OS benefit relative to sunitinib were 
      included: CheckMate 214 (nivolumab plus ipilimumab [N+I]), KEYNOTE-426 
      (pembrolizumab plus axitinib [P+A]), CheckMate 9ER (nivolumab plus cabozantinib 
      [N+C]) and KEYNOTE-581 (lenvatinib plus permbrolizumab [L+P]). OS represented the 
      primary outcome. PFS, objective response rate and AEs represented secondary 
      outcomes. RESULTS: Overall, 3,320 patients were included. Regarding OS, N+C 
      ranked first, followed by L+P, P+A and N+I. Regarding PFS and objective response 
      rate, L+P ranked first, followed by N+C, P+A and N+I. Finally, N+I ranked first 
      with respect to lowest grade 3+ AEs, followed by P+A, N+C and L+P. Differences in 
      followup duration, risk grouping and nephrectomy rates distinguish the studies. 
      CONCLUSIONS: N+C may provide the most favorable OS, L+P the most favorable PFS 
      and ORRs, and N+I the lowest toxicity. Population differences may potentially 
      undermine the generalizability and the robustness of findings of metastatic renal 
      cell carcinoma.
FAU - Nocera, Luigi
AU  - Nocera L
AUID- ORCID: 0000-0003-3354-8139
AD  - Cancer Prognostics and Health Outcomes Unit, Division of Urology, University of 
      Montreal Health Center, Montreal, Quebec, Canada.
AD  - Division of Experimental Oncology/Unit of Urology, URI, Urological Research 
      Institute, IRCCS San Raffaele Scientific Institute, Milan, Italy.
FAU - Karakiewicz, Pierre I
AU  - Karakiewicz PI
AD  - Cancer Prognostics and Health Outcomes Unit, Division of Urology, University of 
      Montreal Health Center, Montreal, Quebec, Canada.
FAU - Wenzel, Mike
AU  - Wenzel M
AD  - Cancer Prognostics and Health Outcomes Unit, Division of Urology, University of 
      Montreal Health Center, Montreal, Quebec, Canada.
AD  - Department of Urology, University Hospital Frankfurt, Frankfurt am Main, Germany.
FAU - Tian, Zhe
AU  - Tian Z
AD  - Cancer Prognostics and Health Outcomes Unit, Division of Urology, University of 
      Montreal Health Center, Montreal, Quebec, Canada.
FAU - Shariat, Shahrokh F
AU  - Shariat SF
AD  - Department of Urology, Comprehensive Cancer Center, Medical University of Vienna, 
      Vienna, Austria.
AD  - Departments of Urology, Weill Cornell Medical College, New York, New York.
AD  - Department of Urology, University of Texas Southwestern, Dallas, Texas.
AD  - Department of Urology, Second Faculty of Medicine, Charles University, Prague, 
      Czech Republic.
AD  - Institute for Urology and Reproductive Health, I.M. Sechenov First Moscow State 
      Medical University, Moscow, Russia.
AD  - Division of Urology, Department of Special Surgery, Jordan University Hospital, 
      The University of Jordan, Amman, Jordan.
FAU - Saad, Fred
AU  - Saad F
AD  - Cancer Prognostics and Health Outcomes Unit, Division of Urology, University of 
      Montreal Health Center, Montreal, Quebec, Canada.
FAU - Chun, Felix K H
AU  - Chun FKH
AD  - Department of Urology, University Hospital Frankfurt, Frankfurt am Main, Germany.
FAU - Briganti, Alberto
AU  - Briganti A
AD  - Division of Experimental Oncology/Unit of Urology, URI, Urological Research 
      Institute, IRCCS San Raffaele Scientific Institute, Milan, Italy.
FAU - Kapoor, Anil
AU  - Kapoor A
AD  - Juravinski Cancer Centre, McMaster University, Hamilton, Ontario, Canada.
FAU - Lalani, Aly-Khan
AU  - Lalani AK
AD  - Juravinski Cancer Centre, McMaster University, Hamilton, Ontario, Canada.
LA  - eng
PT  - Journal Article
PT  - Meta-Analysis
PT  - Systematic Review
DEP - 20210921
PL  - United States
TA  - J Urol
JT  - The Journal of urology
JID - 0376374
RN  - 0 (Antineoplastic Agents)
SB  - IM
MH  - Antineoplastic Agents/adverse effects/*therapeutic use
MH  - Carcinoma, Renal Cell/*drug therapy/secondary
MH  - Humans
MH  - Kidney Neoplasms/*drug therapy/pathology
MH  - Network Meta-Analysis
MH  - Postoperative Complications/*etiology
MH  - Progression-Free Survival
MH  - Treatment Outcome
OTO - NOTNLM
OT  - immunotherapy
OT  - network meta-analysis
OT  - progression-free survival
OT  - survival rate
EDAT- 2021/09/22 06:00
MHDA- 2022/01/21 06:00
CRDT- 2021/09/21 17:15
PHST- 2021/09/22 06:00 [pubmed]
PHST- 2022/01/21 06:00 [medline]
PHST- 2021/09/21 17:15 [entrez]
AID - 10.1097/JU.0000000000002252 [doi]
PST - ppublish
SO  - J Urol. 2022 Jan;207(1):16-24. doi: 10.1097/JU.0000000000002252. Epub 2021 Sep 
      21.