Medical Oncology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Via Albertoni n.15, Bologna 40138, Italia.
Oncology Unit, Macerata Hospital, Macerata 62100, Italy.
Immunotherapy. 2021 Jun;13(9):783-793. doi: 10.2217/imt-2021-0005. Epub 2021 Apr 28.
Immune checkpoint inhibitor (ICI)-based combinations have become the new standard of primary systemic treatment for metastatic renal cell carcinoma patients. We performed a meta-analysis aimed at evaluating ICIs plus tyrosine kinase inhibitors (TKIs) combinations across International Metastatic Renal Cell Carcinoma Database Consortium (IMDC) risk groups. All the relevant randomized clinical trials were retrieved through Cochrane library, PubMed/Med and EMBASE; three Phase III randomized clinical trials were included. ICI-TKI combinations significantly decreased the risk of death in IMDC poor- and intermediate-risk patients. Conversely, a nonstatistically significant benefit was observed in favorable-risk patients. Our results suggest that IMDC poor-risk patients benefit most from ICI-TKI combinations, while a proportion of metastatic renal cell carcinoma patients could respond to targeted agent monotherapy.
免疫检查点抑制剂（ICI）为基础的联合治疗已成为转移性肾细胞癌患者一线系统治疗的新标准。我们进行了一项荟萃分析，旨在评估国际转移性肾细胞癌数据库联盟（IMDC）风险组中ICI 联合酪氨酸激酶抑制剂（TKI）的疗效。通过 Cochrane 图书馆、PubMed/Med 和 EMBASE 检索了所有相关的随机临床试验，共纳入了三项 III 期随机临床试验。ICI-TKI 联合治疗可显著降低 IMDC 不良和中危患者的死亡风险。相反，在低危患者中观察到的获益无统计学意义。我们的研究结果表明，IMDC 不良风险患者从 ICI-TKI 联合治疗中获益最多，而一部分转移性肾细胞癌患者可能对靶向药物单药治疗有反应。
