Abstract：
OBJECTIVE: To assess comparative effectiveness of adjuvant therapies for renal cell carcinoma and quantify the absolute benefit of adjuvant treatments by clinicopathological risk groups.
METHODS: This \'living\' review was conducted using Living Interactive Evidence (LIvE) synthesis framework.
RESULTS: The \'living\' results are available on an interactive website. This network meta-analysis, including six RCTs with 7525 participants, showed that pembrolizumab (rank 1) significantly improved disease-free survival and overall survival compared with sunitinib but not when compared to pazopanib, and axitinib. The risk of treatment-related grade 3 or higher adverse events was increased with pembrolizumab as compared to placebo and axitinib but not when compared to sunitinib. The absolute benefit of adjuvant pembrolizumab increases substantially with larger tumor size, nodal positivity and higher Leibovich scores.
CONCLUSIONS: Current evidence suggests that pembrolizumab delays disease progression compared to sunitinib. A risk-adapted strategy should be used in patients undergoing consideration for treatment with adjuvant pembrolizumab.
METHODS: This \'living\' review was conducted using Living Interactive Evidence (LIvE) synthesis framework.
RESULTS: The \'living\' results are available on an interactive website. This network meta-analysis, including six RCTs with 7525 participants, showed that pembrolizumab (rank 1) significantly improved disease-free survival and overall survival compared with sunitinib but not when compared to pazopanib, and axitinib. The risk of treatment-related grade 3 or higher adverse events was increased with pembrolizumab as compared to placebo and axitinib but not when compared to sunitinib. The absolute benefit of adjuvant pembrolizumab increases substantially with larger tumor size, nodal positivity and higher Leibovich scores.
CONCLUSIONS: Current evidence suggests that pembrolizumab delays disease progression compared to sunitinib. A risk-adapted strategy should be used in patients undergoing consideration for treatment with adjuvant pembrolizumab.
摘要：
目的：评估肾细胞癌辅助治疗的比较效果，并量化临床病理风险组辅助治疗的绝对益处。
方法：本“生活”综述使用生活互动证据（LIVE）综合框架进行。
结果：\'living\'结果可在交互式网站上找到。这个网络荟萃分析，包括六个RCT，有7525名参与者，显示，与舒尼替尼相比，帕博利珠单抗（等级1）显着改善了无病生存率和总生存率，但与帕唑帕尼相比却没有，和阿西替尼.与安慰剂和阿西替尼相比，派姆单抗治疗相关的3级或更高不良事件的风险增加，但与舒尼替尼相比没有增加。pembrolizumab佐剂的绝对益处随着肿瘤尺寸的增大而显著增加，淋巴结阳性和较高的莱博维奇分数。
结论：目前的证据表明，与舒尼替尼相比，派姆单抗可延缓疾病进展。考虑使用派姆单抗辅助治疗的患者应使用风险适应策略。
方法：本“生活”综述使用生活互动证据（LIVE）综合框架进行。
结果：\'living\'结果可在交互式网站上找到。这个网络荟萃分析，包括六个RCT，有7525名参与者，显示，与舒尼替尼相比，帕博利珠单抗（等级1）显着改善了无病生存率和总生存率，但与帕唑帕尼相比却没有，和阿西替尼.与安慰剂和阿西替尼相比，派姆单抗治疗相关的3级或更高不良事件的风险增加，但与舒尼替尼相比没有增加。pembrolizumab佐剂的绝对益处随着肿瘤尺寸的增大而显著增加，淋巴结阳性和较高的莱博维奇分数。
结论：目前的证据表明，与舒尼替尼相比，派姆单抗可延缓疾病进展。考虑使用派姆单抗辅助治疗的患者应使用风险适应策略。
