PMID- 36709462
OWN - NLM
STAT- MEDLINE
DCOM- 20230425
LR  - 20231027
IS  - 1464-410X (Electronic)
IS  - 1464-4096 (Linking)
VI  - 131
IP  - 5
DP  - 2023 May
TI  - Adjuvant immunotherapy in renal cell carcinoma: a systematic review and 
      meta-analysis.
PG  - 553-561
LID - 10.1111/bju.15981 [doi]
AB  - OBJECTIVES: To synthesise available data regarding the disease-free survival 
      (DFS) benefit of adjuvant immune checkpoint inhibitors (ICIs) for patients with 
      renal cell carcinoma (RCC) and evaluate the overall safety profile of ICIs in 
      this setting. MATERIALS AND METHODS: We utilised PubMed, Embase, and relevant 
      conference proceedings to identify phase III randomised controlled trials 
      comparing adjuvant ICIs vs placebo/observation for RCC. The primary outcome of 
      interest was DFS. Variables for subgroup analyses were programmed death-ligand 1 
      (PD-L1) expression, sarcomatoid features, nephrectomy type, and disease-risk 
      category. Secondary outcomes included Grade >/=3 adverse events (AEs), 
      immune-related AEs, and treatment discontinuation due to AEs. All outcomes were 
      analysed using random-effects models owing to inter-study heterogeneity. RESULTS: 
      Among the four included studies, one demonstrated a significant DFS benefit. 
      There was considerable clinical and statistical heterogeneity (I(2)  = 64%) due 
      to differences in inclusion criteria and interventions. While pooled results 
      across the four studies did not demonstrate a significant benefit in DFS overall 
      (hazard ratio [HR] 0.85, 95% confidence interval [CI] 0.69-1.04) there was 
      significant benefit among patients with positive PD-L1 expression (HR 0.72, 95% 
      CI 0.55-0.94) and sarcomatoid features (HR 0.59, 95% CI 0.38-0.91). CONCLUSION: 
      The evidence base to date regarding ICIs as adjuvant therapy in RCC is mixed - 
      conclusions are limited by considerable heterogeneity between studies. However, 
      pooled analyses suggest that patients with positive PD-L1 expression or 
      sarcomatoid features are most likely to benefit from adjuvant immunotherapy.
CI  - (c) 2023 BJU International.
FAU - Riveros, Carlos
AU  - Riveros C
AUID- ORCID: 0000-0001-8030-6605
AD  - Department of Urology, Houston Methodist Hospital, Houston, TX, USA.
FAU - Huang, Emily
AU  - Huang E
AD  - Department of Urology, Houston Methodist Hospital, Houston, TX, USA.
FAU - Ranganathan, Sanjana
AU  - Ranganathan S
AD  - Department of Urology, Houston Methodist Hospital, Houston, TX, USA.
FAU - Klaassen, Zachary
AU  - Klaassen Z
AUID- ORCID: 0000-0001-7392-8916
AD  - Division of Urology, Medical College of Georgia, Augusta University, Augusta, GA, 
      USA.
FAU - Rini, Brian
AU  - Rini B
AD  - Division of Hematology and Oncology, Vanderbilt University Medical Center, 
      Nashville, TN, USA.
FAU - Wallis, Christopher J D
AU  - Wallis CJD
AUID- ORCID: 0000-0002-5990-4026
AD  - Division of Urology and Surgical Oncology, Department of Surgery, Princess 
      Margaret Cancer Centre, University Health Network, University of Toronto, 
      Toronto, ON, Canada.
AD  - Division of Urology, University of Toronto, Toronto, ON, Canada.
AD  - Division of Urology, Mount Sinai Hospital, Toronto, ON, Canada.
FAU - Satkunasivam, Raj
AU  - Satkunasivam R
AD  - Department of Urology, Houston Methodist Hospital, Houston, TX, USA.
LA  - eng
PT  - Journal Article
PT  - Meta-Analysis
PT  - Review
PT  - Systematic Review
DEP - 20230228
PL  - England
TA  - BJU Int
JT  - BJU international
JID - 100886721
RN  - 0 (B7-H1 Antigen)
RN  - 0 (Adjuvants, Immunologic)
SB  - IM
CIN - J Urol. 2023 Nov;210(5):818-821. PMID: 37615289
MH  - Humans
MH  - *Carcinoma, Renal Cell/drug therapy
MH  - B7-H1 Antigen
MH  - Disease-Free Survival
MH  - Immunotherapy/methods
MH  - Adjuvants, Immunologic/therapeutic use
MH  - *Kidney Neoplasms/drug therapy
OTO - NOTNLM
OT  - #KidneyCancer
OT  - #kcsm
OT  - #uroonc
OT  - adjuvant
OT  - disease-free survival
OT  - immunotherapy
OT  - renal cell carcinoma
OT  - safety
EDAT- 2023/01/30 06:00
MHDA- 2023/04/25 06:42
CRDT- 2023/01/29 14:06
PHST- 2023/04/25 06:42 [medline]
PHST- 2023/01/30 06:00 [pubmed]
PHST- 2023/01/29 14:06 [entrez]
AID - 10.1111/bju.15981 [doi]
PST - ppublish
SO  - BJU Int. 2023 May;131(5):553-561. doi: 10.1111/bju.15981. Epub 2023 Feb 28.