Aim: To compare the efficacy of first-line immune checkpoint inhibitor (ICI)-based combinations in metastatic renal cell carcinoma (mRCC) patients stratified by chronological age. Methods: According to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, hazard ratios for overall survival (OS) from randomized controlled trials were synthesized. Results: Five RCTs were eligible for meta-analyses. ICI-based combinations significantly improved OS compared with sunitinib alone, both in younger (<65 years) and older (≥65 years) patients, whereas the OS benefit was significantly better in younger patients (p = 0.007). ICI-based combinations did not improve OS in patients aged ≥75 years. Treatment rankings showed age-related differential recommendations regarding improved OS. Conclusion: OS benefit from first-line ICI-based combinations was significantly greater in younger patients. Age-related differences could help enrich shared decision-making.
Scientists have found a special way to treat a type of cancer called metastatic renal cell carcinoma. They use a combination of medicines that help the body's immune system fight cancer. These treatments are very effective and recommended as the first choice for patients with this type cancer. However, as people get older, their immune systems may not work as well. Studies looking at how these treatments work in different age groups, and it was discovered that these treatments improved the chances of survival for all patients, no matter their age. However, they also noticed that younger patients got even more benefits from the treatments. Because of these discoveries, doctors can now make better decisions about which treatment to use for patients with this type of cancer, depending on patient age.
Immunotherapy. 2023 Sep 11 [Epub ahead of print]
Takafumi Yanagisawa, Fahad Quhal, Tatsushi Kawada, Kensuke Bekku, Ekaterina Laukhtina, Pawel Rajwa, Markus von Deimling, Marcin Chlosta, Benjamin Pradere, Pierre I Karakiewicz, Keiichiro Mori, Takahiro Kimura, Manuela Schmidinger, Shahrokh F Shariat
Department of Urology, Comprehensive Cancer Center, Medical University of Vienna, Vienna, 1090, Austria., Cancer Prognostics & Health Outcomes Unit, Division of Urology, University of Montreal Health Center, Montreal, QC, H2X 0A9, Canada., Department of Urology, The Jikei University School of Medicine, Tokyo, 105-8461, Japan.