Sorafenib exhibits lower toxicity and comparable efficacy to sunitinib as a first-line treatment for metastatic renal cell carcinoma: A systematic review and meta-analysis.

BACKGROUND: To assess the safety and efficacy of sorafenib and sunitinib as first-line treatments for metastatic renal cell carcinoma (mRCC), to provide evidence-based support for clinical decision-making regarding rational drug use. METHODS: Until May 10, 2023, a comprehensive search was conducted across PubMed, EMBASE, Cochrane Library, ClinicalTrials.gov, China National Knowledge Infrastructure, and Wanfang databases to identify clinical studies comparing sorafenib with sunitinib as first-line treatment for mRCC. The literature was screened, data extracted, and quality evaluated independently by 2 researchers. Meta-analysis was conducted using Revman5.4 software. RESULTS: A total of 3741 patients were enrolled in 20 studies. The meta-analysis results indicated that there were no significant differences in the 2- and 5-year progression-free survival (PFS) and overall survival (OS) rates between the sorafenib and sunitinib groups (P > .05). The disease control rate (DCR) was comparable between the 2 groups (P > .05), while the objective response rate (ORR) was higher in the sunitinib group (P = .03). However, subgroup analysis revealed no significant differences in ORR, DCR, 2- and 5-year PFS, and OS rates between sorafenib and sunitinib among both Asian populations as well as European and American populations (P > .05). In terms of drug-related adverse events, the incidence of grade ≥ 3 hypertension, leukopenia, neutropenia, thrombocytopenia, anemia, nausea and vomiting were significantly lower in the sorafenib group compared to the sunitinib group (P < .05). CONCLUSION: In the first-line treatment of mRCC, sorafenib exhibits comparable efficacy to sunitinib but with lower toxicity.

Molecular mechanism of enhancing the immune effect of the Newcastle disease virus vaccine in broilers fed with Bacillus cereus PAS38.

The aim of this study was to explore the molecular mechanism of enhancing the immune effect of the Newcastle disease virus (NDV) vaccine in broilers fed with Bacillus cereus PAS38. The results showed that the NDV antibody titer of broilers in the treatment group supplemented with B. cereus PAS38 was higher than that of the control group, and the difference was significant at 28 days of age (P < 0.05). The spleen, thymus and bursa of fabricius of 42-day-old broilers were quickly collected to construct a differentially expressed gene library of suppression subtractive hybridization (SSH). A total of 31 immune-related differentially expressed genes were screened from three immune organs, of which 15 were up-regulated and 16 were down-regulated. After silencing the up-regulated genes MIF, CD74, DOCK2 and KLHL6, the expression levels of cytokines (Akirin2, NF-κB, IL-2, IL-4, IL-6, IFN-γ and TNF-α) in lymphocytes were reduced to varying degrees. B. cereus PAS38 might be involved in the proliferation, differentiation, activation, migration of B lymphocytes and vaccine antigen presentation by up-regulating the expression of MIF, CD74, DOCK2, KLHL6 and other genes. Moreover, it also stimulated plasma cells to produce immunoglobulins and specific antibodies, thereby improving the humoral immune function of broilers and enhancing the immune effect of the NDV vaccine.