PMID- 38390328
OWN - NLM
STAT- MEDLINE
DCOM- 20240226
LR  - 20240320
IS  - 1664-3224 (Electronic)
IS  - 1664-3224 (Linking)
VI  - 15
DP  - 2024
TI  - Efficacy and toxicity of immune checkpoint inhibitors combination therapy for 
      advanced renal cell carcinoma: a systematic review and network meta-analysis.
PG  - 1255577
LID - 10.3389/fimmu.2024.1255577 [doi]
LID - 1255577
AB  - BACKGROUND: Although immune checkpoint inhibitors (ICIs) show a significant 
      overall survival advantage over standard advanced renal cell carcinoma (aRCC) 
      therapies, tumor response to these agents remains poor. Some studies have shown 
      that combination therapy including an ICI appears to be the best treatment; 
      however, the overall benefit in terms of efficacy and toxicity still needs to be 
      assessed. Thus, we performed a network meta-analysis to evaluate the differences 
      in the efficacy of several combinations that include an ICI to provide a basis 
      for clinical treatment selection. METHODS: We conducted a thorough search of 
      PubMed, EMBASE, and the Cochrane Library for articles from January 2010 to June 
      2023. R 4.4.2 and STATA 16.0 were used to analyze data; hazard ratio (HR) and 
      odds ratio (OR) with 95% confidence intervals (CI) were used to assess the 
      results. RESULTS: An indirect comparison showed that nivolumab plus cabozantinib 
      and pembrolizumab plus lenvatinib were the most effective treatments for 
      progression-free survival (PFS), with no significant differences between the two 
      interventions (HR, 1.31; 95% CI, 0.96-1.78; P=0.08); rank probability showed that 
      pembrolizumab plus lenvatinib had a 57.1% chance of being the preferred 
      treatment. In the absence of indirect comparisons between pembrolizumab plus 
      axitinib, nivolumab plus ipilimumab, avelumab plus axitinib, nivolumab plus 
      cabozantinib, and pembrolizumab plus lenvatinib, pembrolizumab plus axitinib 
      (40.2%) was the best treatment option for overall survival (OS). Compared to 
      pembrolizumab plus lenvatinib, nivolumab plus ipilimumab (OR, 0.07; 95% CI, 
      0.01-0.65; P=0.02) and pembrolizumab plus axitinib (OR, 0.05; 95% CI, 0.00-0.78; 
      P<0.001) had a lower incidence of overall adverse events (AEs). CONCLUSION: 
      Pembrolizumab plus lenvatinib and pembrolizumab plus axitinib resulted in the 
      highest PFS and OS rates, respectively. Pembrolizumab plus axitinib may be the 
      best option when AEs are a concern. SYSTEMATIC REVIEW REGISTRATION: 
      https://inplasy.com/, identifier INPLASY202410078.
CI  - Copyright (c) 2024 Chen, Xu, Wu, Xie, Wang and Liu.
FAU - Chen, Xiangyu
AU  - Chen X
AD  - Department of Urology, Tianjin Medical University General Hospital, Tianjin, 
      China.
FAU - Xu, Zhunan
AU  - Xu Z
AD  - Department of Urology, Tianjin Medical University General Hospital, Tianjin, 
      China.
FAU - Wu, Changgui
AU  - Wu C
AD  - Department of Urology, Tianjin Medical University General Hospital, Tianjin, 
      China.
FAU - Xie, Lijun
AU  - Xie L
AD  - Department of Urology, Tianjin Medical University General Hospital, Tianjin, 
      China.
FAU - Wang, Pengyu
AU  - Wang P
AD  - Department of Urology, Tianjin Medical University General Hospital, Tianjin, 
      China.
FAU - Liu, Xiaoqiang
AU  - Liu X
AD  - Department of Urology, Tianjin Medical University General Hospital, Tianjin, 
      China.
LA  - eng
PT  - Journal Article
PT  - Meta-Analysis
PT  - Systematic Review
DEP - 20240208
PL  - Switzerland
TA  - Front Immunol
JT  - Frontiers in immunology
JID - 101560960
RN  - EE083865G2 (lenvatinib)
RN  - 1C39JW444G (cabozantinib)
RN  - C9LVQ0YUXG (Axitinib)
RN  - 31YO63LBSN (Nivolumab)
RN  - 0 (Immune Checkpoint Inhibitors)
RN  - 0 (Ipilimumab)
RN  - 0 (Anilides)
RN  - 0 (Phenylurea Compounds)
RN  - 0 (Pyridines)
RN  - 0 (Quinolines)
SB  - IM
MH  - Humans
MH  - *Carcinoma, Renal Cell/pathology
MH  - Axitinib/therapeutic use
MH  - Nivolumab/therapeutic use
MH  - Immune Checkpoint Inhibitors/adverse effects
MH  - Ipilimumab/therapeutic use
MH  - Network Meta-Analysis
MH  - *Kidney Neoplasms/pathology
MH  - *Anilides
MH  - *Phenylurea Compounds
MH  - *Pyridines
MH  - *Quinolines
PMC - PMC10881808
OTO - NOTNLM
OT  - advanced renal cell carcinoma
OT  - combination therapy
OT  - efficacy
OT  - immune checkpoint inhibitors
OT  - tyrosine kinase inhibitors
COIS- The authors declare that the research was conducted in the absence of any 
      commercial or financial relationships that could be construed as a potential 
      conflict of interest.
EDAT- 2024/02/23 06:43
MHDA- 2024/02/26 06:43
PMCR- 2024/01/01
CRDT- 2024/02/23 03:55
PHST- 2023/07/09 00:00 [received]
PHST- 2024/01/25 00:00 [accepted]
PHST- 2024/02/26 06:43 [medline]
PHST- 2024/02/23 06:43 [pubmed]
PHST- 2024/02/23 03:55 [entrez]
PHST- 2024/01/01 00:00 [pmc-release]
AID - 10.3389/fimmu.2024.1255577 [doi]
PST - epublish
SO  - Front Immunol. 2024 Feb 8;15:1255577. doi: 10.3389/fimmu.2024.1255577. 
      eCollection 2024.