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Immunotherapy-based combinations versus standard first-line treatment for metastatic clear cell renal cell carcinoma: a systematic review and meta-analysis

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A Correspondence to this article was published on 20 April 2020

Abstract

Purpose

Considering the recent publication of the results of several clinical trials for metastatic clear cell renal cell carcinoma (mRCC), we performed a systematic review and meta-analysis of randomized studies comparing standard first-line VEGFR-targeted therapy to immune checkpoint inhibitors-based combinations for mRCC patients.

Methods

3960 patients from 5 randomized clinical trials where available for evaluation.

Result

In the all-comers population, immunotherapy-based combinations were able to decrease the risk of death over the standard of care by 26% (HR 0.74; 95% CI 0.60–0.92; p = 0.006), to decrease the risk of progression by 21% (HR 0.79; 95% CI 0.72–0.86; p < 0.00001), and to increase the relative risk of response by 40% (HR 1.40; 95% CI 1.11–1.77; p = 0.006). For poor/intermediate-risk patients, the risk of death is decreased by 41% and the risk of progression by 27%.

Conclusions

The benefit of immunotherapy-based combinations in mRCC patients is independent from the IMDC risk group, but it is stronger for poor/intermediate-risk patients.

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Authors and Affiliations

  1. Medical Oncology Unit, University Hospital of Parma, Parma, Italy

    Sebastiano Buti & Melissa Bersanelli

  2. Medical Oncology Unit, Medical Sciences Department, ASST Bergamo Ovest, Piazzale Ospedale 1, 24047, Treviglio, BG, Italy

    Fausto Petrelli

  3. Oncology Unit, Casa di Cura Igea, Milan, Italy

    Antonio Ghidini

  4. Urology Unit, ASST Bergamo Ovest, Treviglio, BG, Italy

    Ivano Vavassori

  5. Urology Unit, University Hospital of Parma, Parma, Italy

    Umberto Maestroni

  6. Medicine and Surgery Department, University of Parma, Parma, Italy

    Melissa Bersanelli

Authors
  1. Sebastiano Buti
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  2. Fausto Petrelli
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  3. Antonio Ghidini
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  4. Ivano Vavassori
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  5. Umberto Maestroni
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  6. Melissa Bersanelli
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Corresponding author

Correspondence to Fausto Petrelli.

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Conflict of interest

Dr. Bersanelli received research funding by Roche, Pfizer, Seqirus, AstraZeneca, Bristol-Myers Squibb, Novartis, and Sanofi; she also received honoraria for advisory role and as speaker at scientific events by Bristol-Myers Squibb, Novartis, and Pfizer. Dr. Buti received honoraria for advisory role and as speaker at scientific events by Bristol-Myers Squibb, Novartis, IPSEN, and AstraZeneca. All other authors have no conflict of interest to declare.

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Buti, S., Petrelli, F., Ghidini, A. et al. Immunotherapy-based combinations versus standard first-line treatment for metastatic clear cell renal cell carcinoma: a systematic review and meta-analysis. Clin Transl Oncol 22, 1657–1663 (2020). https://doi.org/10.1007/s12094-020-02292-z

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  • DOI: https://doi.org/10.1007/s12094-020-02292-z

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