Immune-Based Combinations for the Treatment of Metastatic Renal Cell Carcinoma: A Meta-Analysis of Randomised Clinical Trials - Beyond the Abstract
We retrieved all the relevant trials published from 15th June 2008 to 24th February 2021, evaluating immune-based combinations in treatment-naïve mRCC through PubMed/MEDLINE, Cochrane library, and EMBASE; additionally, proceedings of the main international oncological meetings were also searched for relevant abstracts. Outcomes of interest included overall survival (OS), progression-free survival (PFS), complete response (CR) rate, and overall response rate (ORR). Hazard ratios (HRs) and their 95% confidence intervals (CIs) for OS and PFS, and odds ratios (ORs) and 95% CIs for CR rate and ORR, were extracted.
Overall, 6 phase III studies involving 5175 treatment-naïve mRCC patients were available for the meta-analysis. According to our results, the use of immune-based combinations decreased the risk of death by 26% (HR 0.74, 95% CI 0.67-0.81, P < 0.001); similarly, a PFS benefit was observed (HR 0.68, 95% CI 0.54-0.85, P < 0.001). In addition, immune-based combinations showed better CR rate and ORR, with ORs of 3.04 (95% CI 2.31-3.99, P < 0.001) and 2.53 (95% CI 1.77-3.62, P < 0.03), respectively.
The results of our meta-analysis confirm the clinical benefit provided by immunotherapy combinations, with CR rate more than tripled in mRCCs receiving immune-based combinations. Further studies in a real-world setting are warranted to validate the findings of our meta-analysis, the most updated to systematically evaluate immune-based combinations in mRCC.
Written by: Francesco Massari, MD, Dirigente Medico, U.O. Oncologia Medica IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bolognam, Italy
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