PDF(Pubmed)
Abstract：
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.
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.
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).
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.
https://inplasy.com/, identifier INPLASY202410078.
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.
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).
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.
https://inplasy.com/, identifier INPLASY202410078.
摘要：
尽管免疫检查点抑制剂（ICIs）比标准晚期肾细胞癌（aRCC）疗法显示出显著的总体生存优势，肿瘤对这些药物的反应仍然很差。一些研究表明，包括ICI在内的联合治疗似乎是最好的治疗方法；然而，在疗效和毒性方面的总体获益仍需评估.因此，我们进行了网络荟萃分析,以评估包括ICI在内的几种组合的疗效差异,为临床治疗选择提供依据.
■我们对PubMed进行了彻底的搜索，EMBASE,和Cochrane图书馆的文章从2010年1月到2023年6月。R4.4.2和STATA16.0用于分析数据；风险比（HR）和比值比（OR）以及95％置信区间（CI）用于评估结果。
■间接比较显示，纳武单抗联合卡博替尼和派博利珠单抗联合乐伐替尼是无进展生存期（PFS）最有效的治疗方法，两种干预措施之间没有显著差异(HR，1.31；95%CI，0.96-1.78；P=0.08）；等级概率显示，派姆单抗联合乐伐替尼成为首选治疗的可能性为57.1%。在pembrolizumab+axitinib之间没有间接比较的情况下，nivolumab加ipilimumab,阿维鲁单抗加阿西替尼，纳武单抗加卡博替尼，和派博利珠单抗加乐伐替尼，派姆单抗联合阿西替尼(40.2%)是总生存期(OS)的最佳治疗选择.与派博利珠单抗加乐伐替尼相比，nivolumab+ipilimumab(OR，0.07；95%CI，0.01-0.65；P=0.02）和派姆单抗联合阿西替尼（OR，0.05；95%CI，0.00-0.78；P<0.001）的总不良事件（AE）发生率较低。
■Pembrolizumab+lenvatinib和pembrolizumab+axitinib导致最高的PFS和OS率，分别。当AE令人担忧时，派姆单抗加阿西替尼可能是最佳选择。
■https://inplasy.com/,标识符INPLASY202410078。
■我们对PubMed进行了彻底的搜索，EMBASE,和Cochrane图书馆的文章从2010年1月到2023年6月。R4.4.2和STATA16.0用于分析数据；风险比（HR）和比值比（OR）以及95％置信区间（CI）用于评估结果。
■间接比较显示，纳武单抗联合卡博替尼和派博利珠单抗联合乐伐替尼是无进展生存期（PFS）最有效的治疗方法，两种干预措施之间没有显著差异(HR，1.31；95%CI，0.96-1.78；P=0.08）；等级概率显示，派姆单抗联合乐伐替尼成为首选治疗的可能性为57.1%。在pembrolizumab+axitinib之间没有间接比较的情况下，nivolumab加ipilimumab,阿维鲁单抗加阿西替尼，纳武单抗加卡博替尼，和派博利珠单抗加乐伐替尼，派姆单抗联合阿西替尼(40.2%)是总生存期(OS)的最佳治疗选择.与派博利珠单抗加乐伐替尼相比，nivolumab+ipilimumab(OR，0.07；95%CI，0.01-0.65；P=0.02）和派姆单抗联合阿西替尼（OR，0.05；95%CI，0.00-0.78；P<0.001）的总不良事件（AE）发生率较低。
■Pembrolizumab+lenvatinib和pembrolizumab+axitinib导致最高的PFS和OS率，分别。当AE令人担忧时，派姆单抗加阿西替尼可能是最佳选择。
■https://inplasy.com/,标识符INPLASY202410078。
