PMID- 34992006
OWN - NLM
STAT- MEDLINE
DCOM- 20220504
LR  - 20220531
IS  - 2588-9311 (Electronic)
IS  - 2588-9311 (Linking)
VI  - 5
IP  - 1
DP  - 2022 Feb
TI  - Pembrolizumab outperforms tyrosine kinase inhibitors as adjuvant treatment in 
      patients with high-risk renal cell carcinoma after nephrectomy.
PG  - 120-124
LID - S2588-9311(21)00223-6 [pii]
LID - 10.1016/j.euo.2021.12.007 [doi]
AB  - We determined the oncologic outcomes and safety profiles of adjuvant immune 
      checkpoint inhibitors (ICIs) compared to adjuvant tyrosine kinase inhibitors 
      (TKIs) in patients at high risk after nephrectomy for clinically nonmetastatic 
      renal cell carcinoma (RCC). Network meta-analyses were conducted for disease-free 
      survival (DFS), overall survival (OS), and adverse events (AEs) with placebo as 
      the common comparator arm. Six trials (KEYNOTE-564, S-TRAC, ASSURE, PROTECT, 
      ATLAS, and SORCE) were included in our analysis. Compared to placebo, both 
      pembrolizumab (hazard ratio [HR] 0.68, 95% confidence interval [CI] 0.51-0.92) 
      and pazopanib 800 mg (HR 0.69, 95% CI 0.49-0.97) were significantly associated 
      with better DFS. Adjuvant pembrolizumab (HR 0.54, 95% CI 0.30-0.97) was 
      significantly associated with better OS compared to TKIs (HR 0.93, 95% CI 
      0.83-1.04). Analysis of treatment ranking revealed that pembrolizumab was the 
      best treatment with regard to both DFS and OS and had the lowest likelihood of 
      any-grade and high-grade AEs in comparison to TKIs. The superior oncologic 
      benefit of pembrolizumab and its better toxicity profile support it as the new 
      standard of care in the adjuvant setting for nephrectomy patients at high risk of 
      RCC relapse. PATIENT SUMMARY: For patients with kidney cancer at high risk of 
      relapse after surgical removal of their kidney, postoperative therapy with the 
      immune checkpoint inhibitor pembrolizumab offers the best risk/benefit ratio.
CI  - Copyright (c) 2021 European Association of Urology. Published by Elsevier B.V. All 
      rights reserved.
FAU - Laukhtina, Ekaterina
AU  - Laukhtina E
AD  - Department of Urology, Comprehensive Cancer Center, Medical University of Vienna, 
      Vienna, Austria; Institute for Urology and Reproductive Health, Sechenov 
      University, Moscow, Russia.
FAU - Quhal, Fahad
AU  - Quhal F
AD  - Department of Urology, Comprehensive Cancer Center, Medical University of Vienna, 
      Vienna, Austria; Department of Urology, King Fahad Specialist Hospital, Dammam, 
      Saudi Arabia.
FAU - Mori, Keiichiro
AU  - Mori K
AD  - Department of Urology, Comprehensive Cancer Center, Medical University of Vienna, 
      Vienna, Austria; Department of Urology, The Jikei University School of Medicine, 
      Tokyo, Japan.
FAU - Sari Motlagh, Reza
AU  - Sari Motlagh R
AD  - Department of Urology, Comprehensive Cancer Center, Medical University of Vienna, 
      Vienna, Austria; Men's Health and Reproductive Health Research Center, Shahid 
      Beheshti University of Medical Sciences, Tehran, Iran.
FAU - Rajwa, Pawel
AU  - Rajwa P
AD  - Department of Urology, Comprehensive Cancer Center, Medical University of Vienna, 
      Vienna, Austria; Department of Urology, Medical University of Silesia, Zabrze, 
      Poland.
FAU - Yanagisawa, Takafumi
AU  - Yanagisawa T
AD  - Department of Urology, Comprehensive Cancer Center, Medical University of Vienna, 
      Vienna, Austria; Department of Urology, The Jikei University School of Medicine, 
      Tokyo, Japan.
FAU - Mostafaei, Hadi
AU  - Mostafaei H
AD  - Department of Urology, Comprehensive Cancer Center, Medical University of Vienna, 
      Vienna, Austria; Research Center for Evidence Based Medicine, Tabriz University 
      of Medical Sciences, Tabriz, Iran.
FAU - Konig, Frederik
AU  - Konig F
AD  - Department of Urology, Comprehensive Cancer Center, Medical University of Vienna, 
      Vienna, Austria; Department of Urology, University Medical Centre 
      Hamburg-Eppendorf, Hamburg, Germany.
FAU - Aydh, Abdulmajeed
AU  - Aydh A
AD  - Department of Urology, Comprehensive Cancer Center, Medical University of Vienna, 
      Vienna, Austria; Department of Urology, King Faisal Medical City, Abha, Saudi 
      Arabia.
FAU - Pradere, Benjamin
AU  - Pradere B
AD  - Department of Urology, Comprehensive Cancer Center, Medical University of Vienna, 
      Vienna, Austria.
FAU - Enikeev, Dmitry
AU  - Enikeev D
AD  - Institute for Urology and Reproductive Health, Sechenov University, Moscow, 
      Russia.
FAU - Karakiewicz, Pierre I
AU  - Karakiewicz PI
AD  - Cancer Prognostics and Health Outcomes Unit, Division of Urology, University of 
      Montreal Health Center, Montreal, Canada.
FAU - Schmidinger, Manuela
AU  - Schmidinger M
AD  - Department of Urology, Comprehensive Cancer Center, Medical University of Vienna, 
      Vienna, Austria.
FAU - Shariat, Shahrokh F
AU  - Shariat SF
AD  - Department of Urology, Comprehensive Cancer Center, Medical University of Vienna, 
      Vienna, Austria; Institute for Urology and Reproductive Health, Sechenov 
      University, Moscow, Russia; Department of Urology, Weill Cornell Medical College, 
      New York, NY, USA; Department of Urology, University of Texas Southwestern, 
      Dallas, TX, USA; Department of Urology, Second Faculty of Medicine, Charles 
      University, Prague, Czech Republic; Karl Landsteiner Institute of Urology and 
      Andrology, Vienna, Austria; Hourani Center for Applied Scientific Research, 
      Al-Ahliyya Amman University, Amman, Jordan. Electronic address: 
      shahrokh.shariat@meduniwien.ac.at.
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20220103
PL  - Netherlands
TA  - Eur Urol Oncol
JT  - European urology oncology
JID - 101724904
RN  - 0 (Antibodies, Monoclonal, Humanized)
RN  - 0 (Immune Checkpoint Inhibitors)
RN  - 0 (Protein Kinase Inhibitors)
RN  - DPT0O3T46P (pembrolizumab)
SB  - IM
MH  - Antibodies, Monoclonal, Humanized
MH  - *Carcinoma, Renal Cell/drug therapy/pathology/surgery
MH  - Chemotherapy, Adjuvant
MH  - Female
MH  - Humans
MH  - *Immune Checkpoint Inhibitors/adverse effects
MH  - *Kidney Neoplasms/drug therapy/pathology/surgery
MH  - Male
MH  - Neoplasm Recurrence, Local/drug therapy
MH  - Nephrectomy
MH  - Protein Kinase Inhibitors/adverse effects
OTO - NOTNLM
OT  - Adjuvant therapy
OT  - Immune checkpoint inhibitor
OT  - Renal cell carcinoma
OT  - Tyrosine kinase inhibitor
EDAT- 2022/01/08 06:00
MHDA- 2022/05/06 06:00
CRDT- 2022/01/07 06:00
PHST- 2021/10/15 00:00 [received]
PHST- 2021/11/18 00:00 [revised]
PHST- 2021/12/17 00:00 [accepted]
PHST- 2022/01/08 06:00 [pubmed]
PHST- 2022/05/06 06:00 [medline]
PHST- 2022/01/07 06:00 [entrez]
AID - S2588-9311(21)00223-6 [pii]
AID - 10.1016/j.euo.2021.12.007 [doi]
PST - ppublish
SO  - Eur Urol Oncol. 2022 Feb;5(1):120-124. doi: 10.1016/j.euo.2021.12.007. Epub 2022 
      Jan 3.