Department of Urology, Comprehensive Cancer Center, Medical University of Vienna, Vienna, 1090, Austria.
Department of Urology, The Jikei University School of Medicine, Tokyo, 105-8461, Japan.
Immunotherapy. 2023 Oct;15(15):1309-1322. doi: 10.2217/imt-2023-0039. Epub 2023 Sep 11.
To compare the efficacy of first-line immune checkpoint inhibitor (ICI)-based combinations in metastatic renal cell carcinoma (mRCC) patients stratified by chronological age. According to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, hazard ratios for overall survival (OS) from randomized controlled trials were synthesized. Five RCTs were eligible for meta-analyses. ICI-based combinations significantly improved OS compared with sunitinib alone, both in younger (<65 years) and older (≥65 years) patients, whereas the OS benefit was significantly better in younger patients (p = 0.007). ICI-based combinations did not improve OS in patients aged ≥75 years. Treatment rankings showed age-related differential recommendations regarding improved OS. OS benefit from first-line ICI-based combinations was significantly greater in younger patients. Age-related differences could help enrich shared decision-making.
比较按 chronological age（年龄）分层的转移性肾细胞癌 (mRCC) 患者一线免疫检查点抑制剂 (ICI) 联合治疗的疗效。 根据系统评价和荟萃分析的首选报告项目 (PRISMA) 指南，对随机对照试验的总生存期 (OS) 进行了合成。 五项 RCT 符合荟萃分析条件。ICI 联合治疗与舒尼替尼单独治疗相比，无论是在年轻 (<65 岁) 还是老年 (≥65 岁) 患者中，均显著改善了 OS，而年轻患者的 OS 获益显著更好 (p=0.007)。ICI 联合治疗并不能改善年龄≥75 岁患者的 OS。治疗排序显示，年龄相关的差异建议改善 OS。一线 ICI 联合治疗在年轻患者中具有显著的 OS 获益。年龄相关的差异有助于丰富共同决策。
