PMID- 36123840
OWN - NLM
STAT- MEDLINE
DCOM- 20220922
LR  - 20221108
IS  - 1536-5964 (Electronic)
IS  - 0025-7974 (Print)
IS  - 0025-7974 (Linking)
VI  - 101
IP  - 37
DP  - 2022 Sep 16
TI  - Systemic therapies for metastatic renal cell carcinoma in the second-line 
      setting: A systematic review and network meta-analysis.
PG  - e30333
LID - 10.1097/MD.0000000000030333 [doi]
LID - e30333
AB  - OBJECTIVES: To perform a systematic review and network meta-analysis to compare 
      the survival benefit and safety profile of current available second-line 
      treatment options of metastatic renal cell carcinomav. METHODS: PubMed, EMBASE, 
      Web of Science, and Cochrane Library were systematically researched for eligible 
      articles which were published before July 20, 2021. Studies comparing 
      overall/progression free survival (OS/PFS), objective response rate (ORR), and/or 
      adverse events (AEs) in patients with metastatic renal cell carcinomav were 
      included. RESULTS: Nine trials (with 4911 patients) were finally included for 
      final network meta-analysis. Cabozantinib, lenvatinib, and lenvatinib plus 
      everolimus were associated with significantly better PFS, OS, and ORR compared 
      with everolimus, and lenvatinib plus everolimus emerged as the best option. As 
      for grade 3 to 4 AEs, nivolumab showed significantly lower risk of AEs compared 
      with everolimus. Other included treatments were associated with significantly 
      increased risk of AEs. When comprehensively assessed the efficacy and safety of 
      included treatments based on the ranking analysis of PFS, ORR, and grade 3 to 4 
      AEs, lenvatinib plus everolimus, cabozantinib, and nivolumab showed superior 
      efficacy over other treatments, with relatively lower risk of grade 3 to 4 AEs. 
      CONCLUSIONS: Among all included therapies, Lenvatinib plus everolimus was 
      identified as the most effective treatment approach, with the best PFS, OS, and 
      ORR. nivolumab was associated with decreased incidence of grade 3 to 4 AEs among 
      included treatment therapies. When comprehensively evaluated the efficacy and 
      safety of included treatment options, lenvatinib plus everolimus, cabozantinb, 
      and nivolumab were associated with better survival benefits and lower risk of 
      AEs. Future studies should focus on the direct comparison of different 
      second-line treatment in real-world populations.
CI  - Copyright (c) 2022 the Author(s). Published by Wolters Kluwer Health, Inc.
FAU - Liao, Yang
AU  - Liao Y
AD  - Department of Urology, Jiangjin District Central Hospital, Chongqing, China.
FAU - Hou, Haifeng
AU  - Hou H
FAU - Han, Zhenhua
AU  - Han Z
FAU - Liu, Ying
AU  - Liu Y
AUID- ORCID: 0000-0001-9551-268
LA  - eng
PT  - Journal Article
PT  - Meta-Analysis
PT  - Systematic Review
PL  - United States
TA  - Medicine (Baltimore)
JT  - Medicine
JID - 2985248R
RN  - 0 (Anilides)
RN  - 0 (Phenylurea Compounds)
RN  - 0 (Pyridines)
RN  - 0 (Quinolines)
RN  - 1C39JW444G (cabozantinib)
RN  - 31YO63LBSN (Nivolumab)
RN  - 9HW64Q8G6G (Everolimus)
RN  - EE083865G2 (lenvatinib)
SB  - IM
MH  - Anilides
MH  - *Carcinoma, Renal Cell/pathology
MH  - Everolimus/therapeutic use
MH  - Humans
MH  - *Kidney Neoplasms/pathology
MH  - Network Meta-Analysis
MH  - Nivolumab
MH  - Phenylurea Compounds
MH  - Pyridines
MH  - Quinolines
PMC - PMC9478350
COIS- The authors have no funding and conflicts of interest to disclose.
EDAT- 2022/09/21 06:00
MHDA- 2022/09/23 06:00
PMCR- 2022/09/16
CRDT- 2022/09/20 01:41
PHST- 2022/09/20 01:41 [entrez]
PHST- 2022/09/21 06:00 [pubmed]
PHST- 2022/09/23 06:00 [medline]
PHST- 2022/09/16 00:00 [pmc-release]
AID - 00005792-202209160-00005 [pii]
AID - 10.1097/MD.0000000000030333 [doi]
PST - ppublish
SO  - Medicine (Baltimore). 2022 Sep 16;101(37):e30333. doi: 
      10.1097/MD.0000000000030333.