二线卡博替尼与纳武利尤单抗治疗晚期肾细胞癌：系统评价和间接治疗比较。
Second-line cabozantinib versus nivolumab in advanced renal cell carcinoma: Systematic review and indirect treatment comparison.
机构信息
Department of Internal Medicine, University of Pavia and Division of Translational Oncology, IRCCS Istituti Clinici Scientifici Maugeri, via S. Maugeri 10, 27100 Pavia, Italy.
Warsaw Medical University, Żwirki i Wigury 61, 02-091 Warsaw, Poland.
出版信息
Crit Rev Oncol Hematol. 2019 Jul;139:143-148. doi: 10.1016/j.critrevonc.2018.10.004. Epub 2018 Oct 24.
BACKGROUND
Nivolumab and cabozantinib, two new treatment options for previously-treated advanced/metastatic renal cell carcinoma (aRCC), have recently been approved.
METHODS
Two independent reviewers performed study selection, data extraction, and risk of bias assessment. Indirect treatment comparisons were carried out by directly assessing HR differences and statistical modeling of Kaplan-Meier curves from these two trials.
RESULTS
Publications identified showed that no head-to-head comparisons had been carried out. Two indirect treatment comparisons used agreed that there was no significant difference in OS between cabozantinib and nivolumab and that cabozantinib significantly improved PFS compared to nivolumab.
CONCLUSIONS
The field of aRCC treatments is evolving rapidly, creating opportunities for individualized treatments and challenges for clinicians to keep up with the evidence. In lieu of availability of direct comparisons of all options, advanced modeling results presented herein can help to inform and improve personalized treatments.
背景
纳武利尤单抗和卡博替尼是两种新的治疗选择，用于治疗既往治疗的晚期/转移性肾细胞癌（aRCC），最近已获得批准。
方法
两名独立的审查员进行了研究选择、数据提取和偏倚风险评估。通过直接评估这两项试验中 HR 差异和 Kaplan-Meier 曲线的统计建模，进行了间接治疗比较。
结果
已确定的出版物表明，尚未进行头对头比较。两项间接治疗比较均认为卡博替尼与纳武利尤单抗在 OS 方面没有显著差异，并且卡博替尼与纳武利尤单抗相比显著改善了 PFS。
结论
aRCC 治疗领域正在迅速发展，为个体化治疗创造了机会，但也给临床医生带来了跟上证据的挑战。由于无法获得所有选择的直接比较，本文介绍的高级建模结果可以帮助提供信息并改善个性化治疗。
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