The average five-year survival of metastatic renal cell carcinoma (mRCC) is 71%. However, there is significant variability in patient prognosis. Immune checkpoint inhibitors (ICIs) have been introduced into the treatment landscape of mRCC. This meta-analysis aimed to estimate progression-free and overall survival probabilities and identify possible outcome predictors of mRCC patients treated with ICI combination as first-line treatment.
Studies comparing the combination of ICI combinations versus standard of therapy for first-line treatment of advanced renal-cell carcinoma were searched in MEDLINE, CANCERLIT, the Cochrane Controlled Trials Register, and the Cochrane Library from inception through September 2023. Data on patient populations and outcomes were extracted from each study by three independent observers and combined using the DerSimonian and Laird methods.
Six studies met the inclusion criteria. Globally, 5121 patients were included in this meta-analysis: 2556 patients treated with immune checkpoint inhibitors and 2565 with sunitinib as control. The ICI combination was associated with improved PFS (hazard ratio (HR) 0.68; 95 % confidence interval (CI), 0.56-0.81, p < 0.0001). Furthermore, ICI combination was also associated with OS improvement (HR 0.85; 95 % CI, 0.78-0.92, p = 0.001). There is no statistical increase in adverse events.
Our findings show that PFS and OS are statistically increased in mRCC with ICI combination treatment by 32% and 15%, respectively.
Cancer treatment reviews. 2024 Apr 27 [Epub ahead of print]
Marcello Tucci, Marta Mandarà, Jacopo Giuliani, Emilia Durante, Consuelo Buttigliero, Fabio Turco, Erica Palesandro, Ilaria Campisi, Navdeep Singh, Marco Muraro, Fernando Munoz, Francesco Fiorica
Department of Medical Oncology, Cardinal Massaia Hospital, 14100 Asti, Italy., Department of Clinical Oncology, Medical Oncology Section, AULSS 9 Scaligera, 37045 Verona, Italy., Department of Oncology, University of Turin, San Luigi Gonzaga Hospital, 10093 Torino, Italy., Medicine and Surgery, University of Turin, Turin, Italy., Department of Clinical Oncology, Radiation Oncology and Nuclear Medicine Section, AULSS 9 Scaligera, 37045 Verona, Italy., Radiation Oncology TomoTherapy Center, Hospital of Aosta, 11000 Aosta, Italy., Department of Clinical Oncology, Medical Oncology Section, AULSS 9 Scaligera, 37045 Verona, Italy; Department of Clinical Oncology, Radiation Oncology and Nuclear Medicine Section, AULSS 9 Scaligera, 37045 Verona, Italy.