To compare the safety profiles of systemic immune checkpoint inhibitor-based combination therapies that were evaluated in the first-line setting of the management of patients with advanced or metastatic renal cell carcinoma (mRCC).
Six phase III randomized control trials comparing first-line immune-based combination therapies to sunitinib in previously untreated patients with mRCC. Network meta-analyses were conducted to compare treatment-related adverse events (TRAEs), treatment discontinuation, and treatment-related mortality.
Lenvatinib plus pembrolizumab was associated with the highest likelihood of grade ≥3 TRAEs, and treatment discontinuation rates. Nivolumab plus ipilimumab was associated with the lowest rates of grade ≥3 TRAEs. However, it was associated with a higher likelihood of endocrine-related adverse events (AEs). A higher likelihood of high-grade diarrhea was associated with pembrolizumab plus axitinib and avelumab plus axitinib. All combinations showed low rates of hematological AEs.
Current opinion in urology. 2021 May 06 [Epub ahead of print]
Fahad Quhal, Keiichiro Mori, Mesut Remzi, Harun Fajkovic, Shahrokh F Shariat, Manuela Schmidinger
Department of Urology, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria Department of Urology, King Fahad Specialist Hospital, Dammam, Saudi Arabia Department of Urology, Jikei University School of Medicine, Tokyo, Japan Karl Landsteiner Institute of Urology and Andrology, Vienna, Austria Department of Urology, Weill Cornell Medical College, New York, New York Department of Urology, University of Texas Southwestern, Dallas, Texas, USA Department of Urology, Second Faculty of Medicine, Charles University, Prague, Czech Republic European Association of Urology Research Foundation, Arnhem, Netherlands Institute for Urology and Reproductive Health, Sechenov University, Moscow, Russia Department of Urology, University of Jordan, Amman, Jordan These authors contributed equally.