■卡博替尼,晚期肾细胞癌(aRCC)的新一线治疗方法,靶向必需酪氨酸激酶,在各种疗效结果中优于已建立的比较剂(舒尼替尼)。本系统评价和荟萃分析旨在评估卡博替尼与其他aRCC治疗相比的疗效和安全性。
■遵循PRISMA和Cochrane指南,我们的协议在PROSPERO注册.系统的搜索,没有日期限制,是在PubMed上进行的,科克伦,WebofScience,和EMBASE直到2023年10月8日。数据提取包括研究细节,基线信息,和结果。每个结果采用95%置信区间的危险比(HR)和风险比(RR)。并应用随机效应模型来解释预期异质性。
■三项研究,包括967名患者,包括在我们的分析中。就功效而言,总生存率的合并率显著有利于卡博替尼.然而,在亚组分析中,卡博替尼仅在统计学上优于依维莫司。对于无进展生存期和肿瘤客观缓解率,卡博替尼的表现优于依维莫司和舒尼替尼.在不良事件中,与舒尼替尼相比,卡博扎替尼在几乎所有评估方面都表现出自卑,除了恶心和口腔炎,两组之间没有差异。相反,在各种副作用中,它显示出与依维莫司相当的风险特征。
■卡博替尼在延长总生存期方面显示出显著疗效,无进展生存期,与舒尼替尼相比,尽管不良事件的风险可能更高,但肿瘤客观缓解率。这些发现支持卡博替尼作为aRCC的一线治疗,作为初始治疗或之前的VEGFR靶向治疗后。
UNASSIGNED: Cabozantinib, a new first-line treatment for advanced renal cell carcinoma (aRCC), targets essential tyrosine kinases and outperforms the established comparator (sunitinib) in various efficacy outcomes. This systematic review and meta-analysis aimed to assess the efficacy and safety of
cabozantinib compared to other aRCC treatments.
UNASSIGNED: Following PRISMA and Cochrane guidelines, our protocol was registered in PROSPERO. A systematic search, without date limits, was conducted on PubMed, Cochrane, Web of Science, and EMBASE until October 8, 2023. Data extraction encompassed study details, baseline information, and outcomes. Hazard ratios (HR) and risk ratios (RR) with 95% confidence intervals were employed for each outcome, and a random-effects model was applied to account for expected heterogeneity.
UNASSIGNED: Three studies, encompassing 967 patients, were included in our analysis. In terms of efficacy, the pooled rate for overall survival significantly favored
cabozantinib. However, in subgroup analyses,
cabozantinib was only statistically superior to everolimus. For progression-free survival and tumor objective response rate, cabozantinib outperformed both everolimus and sunitinib. In adverse events, compared to sunitinib,
cabozantinib exhibited inferiority in nearly all evaluated aspects, except for nausea and stomatitis, which showed no difference between the two groups. Conversely, it demonstrated a comparable risk profile with everolimus across various side effects.
UNASSIGNED: Cabozantinib shows significant efficacy in extending overall survival, progression-free survival, and tumor objective response rate despite a potentially higher risk of adverse events compared to sunitinib. These findings support cabozantinib as a first-line therapy for aRCC, either as an initial treatment or after prior VEGFR-targeted therapies.