Abstract：
OBJECTIVE: Immune checkpoint inhibitors (ICIs) and antibody-drug conjugates (ADCs) herald a transformative era in metastatic renal cell carcinoma (RCC) and transitional cell carcinoma (TCC) treatment, amid acknowledged sex-based disparities in these cancers. We conducted a systematic review and network meta-analysis (NMA) to identify sex-specific differences in the efficacy of ICI/ADC monotherapy or combination therapies for RCC and TCC survival, in metastatic and adjuvant settings.
METHODS: A systematic search was conducted up to October 2023 for English articles on ICIs and ADCs as systemic therapies (ICIs in first-line and adjuvant treatment for RCC, ICIs and ADCs in first- and second-line treatment for TCC). Randomised clinical trials were considered. The primary objective was overall survival (OS) of ICIs and ADCs between males and females. The secondary outcomes included progression-free survival, overall response rate, disease-free survival, and recurrence-free survival. Treatment efficacy was evaluated by sex via odds ratios (ORs) and confidence intervals compared with controls. Log ORs were used for creating a frequentist NMA. This meta-analysis was registered on PROSPERO (CRD42023468632).
UNASSIGNED: Eighteen articles met the inclusion criteria. Females had an advantage for RCC-adjuvant treatment for atezolizumab (log OR [SE] = -0.57 ± 0.25, p = 0.024) in OS. Males showed a survival advantage in TCC second-line treatment for ADC-Nectin 4 (log OR [SE] = 0.65 ± 0.28, p = 0.02). No other significant results were shown.
CONCLUSIONS: The NMA revealed gender-specific variations in ICI and ADC responses for RCC and TCC, offering insights for personalised cancer care and addressing disparities in cancer care and outcomes.
RESULTS: In this systematic review, we looked at the sex differences for metastatic renal cell carcinoma (RCC) and transitional cell carcinoma (TCC) for antibody-drug conjugates and immune checkpoint inhibitors. In our analysis, female and male sex has better overall survival for adjuvant and second-line therapies for RCC and TCC, respectively. Urgent research on gender-specific cancer therapies is imperative.
METHODS: A systematic search was conducted up to October 2023 for English articles on ICIs and ADCs as systemic therapies (ICIs in first-line and adjuvant treatment for RCC, ICIs and ADCs in first- and second-line treatment for TCC). Randomised clinical trials were considered. The primary objective was overall survival (OS) of ICIs and ADCs between males and females. The secondary outcomes included progression-free survival, overall response rate, disease-free survival, and recurrence-free survival. Treatment efficacy was evaluated by sex via odds ratios (ORs) and confidence intervals compared with controls. Log ORs were used for creating a frequentist NMA. This meta-analysis was registered on PROSPERO (CRD42023468632).
UNASSIGNED: Eighteen articles met the inclusion criteria. Females had an advantage for RCC-adjuvant treatment for atezolizumab (log OR [SE] = -0.57 ± 0.25, p = 0.024) in OS. Males showed a survival advantage in TCC second-line treatment for ADC-Nectin 4 (log OR [SE] = 0.65 ± 0.28, p = 0.02). No other significant results were shown.
CONCLUSIONS: The NMA revealed gender-specific variations in ICI and ADC responses for RCC and TCC, offering insights for personalised cancer care and addressing disparities in cancer care and outcomes.
RESULTS: In this systematic review, we looked at the sex differences for metastatic renal cell carcinoma (RCC) and transitional cell carcinoma (TCC) for antibody-drug conjugates and immune checkpoint inhibitors. In our analysis, female and male sex has better overall survival for adjuvant and second-line therapies for RCC and TCC, respectively. Urgent research on gender-specific cancer therapies is imperative.
摘要：
目的：免疫检查点抑制剂（ICIs）和抗体-药物偶联物（ADC）预示着转移性肾细胞癌（RCC）和移行细胞癌（TCC）治疗的变革时代，在这些癌症中公认的基于性别的差异。我们进行了系统评价和网络荟萃分析（NMA），以确定ICI/ADC单一疗法或联合疗法对RCC和TCC生存率的疗效的性别差异。在转移和辅助设置。
方法：直到2023年10月，对关于ICIs和ADC作为全身疗法的英文文章进行了系统搜索（ICIs在RCC的一线和辅助治疗中，ICI和ADC在TCC的一线和二线治疗中的应用)。考虑了随机临床试验。主要目标是男性和女性之间的ICI和ADC的总生存期（OS）。次要结局包括无进展生存期，总反应率，无病生存,和无复发生存。通过与对照组比较的比值比（ORs）和置信区间，通过性别评估治疗效果。日志OR用于创建频率NMA。该荟萃分析在PROSPERO（CRD42023468632）上注册。
■18篇文章符合入选标准。女性在OS中对阿特珠单抗的RCC辅助治疗具有优势（logOR[SE]=-0.57±0.25，p=0.024）。男性在ADC-Nectin4的TCC二线治疗中显示出生存优势（logOR[SE]=0.65±0.28，p=0.02）。没有显示其他显著结果。
结论：NMA揭示了RCC和TCC的ICI和ADC反应的性别特异性变化，提供个性化癌症护理和解决癌症护理和结果差异的见解。
结果：在本系统综述中，我们研究了转移性肾细胞癌(RCC)和移行细胞癌(TCC)在抗体-药物偶联物和免疫检查点抑制剂方面的性别差异.在我们的分析中,女性和男性对于RCC和TCC的辅助和二线治疗具有更好的总体生存率，分别。对性别特异性癌症疗法的紧急研究势在必行。
方法：直到2023年10月，对关于ICIs和ADC作为全身疗法的英文文章进行了系统搜索（ICIs在RCC的一线和辅助治疗中，ICI和ADC在TCC的一线和二线治疗中的应用)。考虑了随机临床试验。主要目标是男性和女性之间的ICI和ADC的总生存期（OS）。次要结局包括无进展生存期，总反应率，无病生存,和无复发生存。通过与对照组比较的比值比（ORs）和置信区间，通过性别评估治疗效果。日志OR用于创建频率NMA。该荟萃分析在PROSPERO（CRD42023468632）上注册。
■18篇文章符合入选标准。女性在OS中对阿特珠单抗的RCC辅助治疗具有优势（logOR[SE]=-0.57±0.25，p=0.024）。男性在ADC-Nectin4的TCC二线治疗中显示出生存优势（logOR[SE]=0.65±0.28，p=0.02）。没有显示其他显著结果。
结论：NMA揭示了RCC和TCC的ICI和ADC反应的性别特异性变化，提供个性化癌症护理和解决癌症护理和结果差异的见解。
结果：在本系统综述中，我们研究了转移性肾细胞癌(RCC)和移行细胞癌(TCC)在抗体-药物偶联物和免疫检查点抑制剂方面的性别差异.在我们的分析中,女性和男性对于RCC和TCC的辅助和二线治疗具有更好的总体生存率，分别。对性别特异性癌症疗法的紧急研究势在必行。
