Rizzo Alessandro, Monteiro Fernando Sabino Marques, Mollica Veronica, Brunetti Oronzo, Vitale Elsa, Sciacovelli Angela Monica, Soares Andrey, Massari Francesco, Santoni Matteo
S.S.D. C.O.r.O. Bed Management Presa in Carico, TDM, IRCCS Istituto Tumori "Giovanni Paolo II", Viale Orazio Flacco 65, 70124, Bari, Italy.
Latin American Cooperative Oncology Group - LACOG, Porto Alegre, RS, Brazil.
Clin Exp Metastasis. 2024 Dec 30;42(1):9. doi: 10.1007/s10585-024-10327-w.
Immune-based combinations have significantly improved the treatment of metastatic renal cell carcinoma (mRCC); however, immunotherapy has reported varying degrees of efficacy across different metastatic sites, with liver and bone metastases traditionally considered more challenging to treat. In MOUSEION-08 study, we aimed to investigate the association between lung, liver, and bone metastases and clinical outcomes such as Overall Survival (OS) and Progression- Free Survival (PFS) in mRCC patients receiving immune-based combinations. The present systematic review and study-level meta-analysis was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA). PFS and OS were measured as Hazard Ratios (HRs) and 95% confidence intervals (CIs). The protocol was registered with PROSPERO, Registration number: CRD42024581488. Our search resulted in the identification of 2364 potentially relevant reports, which were subsequently restricted to three. The pooled HRs for OS and PFS in patients with lung metastases receiving immune-based combinations versus sunitinib were 0.61 (95% CI, 0.51-0.72) and 0.47 (95% CI, 0.38-0.59), respectively. In patients with liver metastases, the pooled HRs for OS and PFS were 0.56 (95% CI, 0.42-0.75) and 0.48 (95% CI, 0.34-0.67), while the pooled HRs for OS and PFS in patients with bone metastases were 0.64 (95% CI, 0.49-0.84) and 0.36 (95% CI, 0.27-0.49), respectively. According to our findings, the analyses reported similar HRs for OS and PFS, something that further underlines the role of immune-based combinations in this setting, regardless of metastatic sites, such as lung, liver, and bone metastases. Ongoing research and clinical trials are destined to refine and improve immunotherapeutic strategies for mRCC, aiming to enhance efficacy across all metastatic sites and to define predictive biomarkers.
基于免疫的联合疗法显著改善了转移性肾细胞癌（mRCC）的治疗；然而，免疫疗法在不同转移部位的疗效报道不一，传统上认为肝转移和骨转移更具治疗挑战性。在MOUSEION - 08研究中，我们旨在调查肺、肝和骨转移与接受基于免疫联合疗法的mRCC患者的总生存期（OS）和无进展生存期（PFS）等临床结局之间的关联。本系统评价和研究水平的荟萃分析是根据系统评价和荟萃分析的首选报告项目（PRISMA）进行的。PFS和OS以风险比（HRs）和95%置信区间（CIs）衡量。该方案已在PROSPERO注册，注册号：CRD42024581488。我们的检索共识别出2364篇潜在相关报告，随后筛选至3篇。接受基于免疫联合疗法的肺转移患者与接受舒尼替尼治疗的患者相比，OS和PFS的汇总HR分别为0.61（95%CI，0.51 - 0.72）和0.47（95%CI，0.38 - 0.59）。肝转移患者的OS和PFS汇总HR分别为0.56（95%CI，0.42 - 0.75）和0.48（95%CI，0.34 - 0.67），而骨转移患者的OS和PFS汇总HR分别为0.64（95%CI，0.49 - 0.84）和0.36（95%CI，0.27 - 0.49）。根据我们的研究结果，分析报告的OS和PFS的HR相似，这进一步强调了基于免疫联合疗法在这种情况下的作用，无论转移部位如何，如肺、肝和骨转移。正在进行的研究和临床试验注定会完善和改进mRCC的免疫治疗策略，旨在提高所有转移部位的疗效并确定预测性生物标志物。
