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Cabozantinib Versus Standard-of-Care Comparators in the Treatment of Advanced/Metastatic Renal Cell Carcinoma in Treatment-naïve Patients: a Systematic Review and Network Meta-Analysis.
Schmidt, Elvira; Lister, Johanna; Neumann, Monika; Wiecek, Witold; Fu, Shuai; Vataire, Anne-Lise; Sostar, Jelena; Huang, Shengnan; Marteau, Florence.
Affiliation
  • Schmidt E; Analytica LA-SER Intl. Inc, Chester Platz 1, 79539, Lörrach, Germany. e.schmidt@analytica-laser.com.
  • Lister J; Analytica LA-SER Intl. Inc, Chester Platz 1, 79539, Lörrach, Germany.
  • Neumann M; Analytica LA-SER Intl. Inc, Chester Platz 1, 79539, Lörrach, Germany.
  • Wiecek W; Analytica LA-SER Intl. Inc, Chester Platz 1, 79539, Lörrach, Germany.
  • Fu S; Analytica LA-SER Intl. Inc, Chester Platz 1, 79539, Lörrach, Germany.
  • Vataire AL; IPSEN Pharma SAS, Boulogne-Billancourt Cedex, France.
  • Sostar J; Analytica LA-SER Intl. Inc, Chester Platz 1, 79539, Lörrach, Germany.
  • Huang S; Analytica LA-SER Intl. Inc, Chester Platz 1, 79539, Lörrach, Germany.
  • Marteau F; IPSEN Pharma SAS, Boulogne-Billancourt Cedex, France.
Target Oncol ; 13(2): 205-216, 2018 04.
Article in En | MEDLINE | ID: mdl-29492762
ABSTRACT

BACKGROUND:

Cabozantinib has recently been evaluated as a first-line treatment in advanced renal cell carcinoma (aRCC).

OBJECTIVE:

To indirectly assess efficacy of cabozantinib versus standard-of-care (SoC) comparators in the first-line treatment of aRCC.

METHODS:

We conducted a systematic literature review (SLR) to identify randomized controlled studies in the first-line setting for aRCC. The outcomes analyzed were overall survival (OS) and progression-free survival (PFS). A network meta-analysis (NMA) was conducted comparing OS and PFS hazard ratios (HRs).

RESULTS:

Thirteen studies were identified in the SLR to be eligible for inclusion in the NMA. The overall study populations were heterogeneous in terms of risk groups; some studies included favorable risk patients. In intermediate-risk patients, HRs (95% confidence interval) for PFS were 0.52 (0.33, 0.82), 0.46 (0.26, 0.80), 0.20 (0.12, 0.36), and 0.37 (0.20, 0.68) when cabozantinib was compared with sunitinib, sorafenib, interferon (IFN), or bevacizumab plus IFN, respectively. In poor-risk patients, the NMA also demonstrated significant superiority in terms of PFS for cabozantinib; HRs were 0.31 (0.11, 0.90), 0.22 (0.06, 0.87), 0.16 (0.04, 0.64), and 0.20 (0.05, 0.88), when cabozantinib was compared with sunitinib, temsirolimus, IFN, or bevacizumab plus IFN, respectively. When the overall study populations were compared, the results were similar to the subgroup analyses. OS HRs in all analyses favored cabozantinib, but were not statistically significant.

CONCLUSIONS:

The results suggest that cabozantinib significantly increases PFS in intermediate-, and poor-risk subgroups when compared to standard-of-care comparators. Although overall populations included favorable risk patients in some studies, the results seen were consistent with the subgroup analyses.
Subject(s)

Full text: 1 Collection: 01-internacional Database: MEDLINE Main subject: Pyridines / Carcinoma, Renal Cell / Anilides Type of study: Clinical_trials / Systematic_reviews Limits: Humans Language: En Journal: Target Oncol Journal subject: NEOPLASIAS Year: 2018 Document type: Article Affiliation country: Germany

Full text: 1 Collection: 01-internacional Database: MEDLINE Main subject: Pyridines / Carcinoma, Renal Cell / Anilides Type of study: Clinical_trials / Systematic_reviews Limits: Humans Language: En Journal: Target Oncol Journal subject: NEOPLASIAS Year: 2018 Document type: Article Affiliation country: Germany