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Efficacy Assessment of Post-nephrectomy Adjuvant Therapies in Patients with Renal Cell Carcinoma.
Ding, Kaiyue; Yang, Zhixuan; Zhang, Danyan; Sun, Lin.
Afiliação
  • Ding K; Department of Nephrology, The Second Xiangya Hospital, Central South University, Changsha, Hunan, China.
  • Yang Z; Hunan Key Laboratory of Kidney Disease and Blood Purification, Changsha, Hunan, China.
  • Zhang D; Department of Nephrology, The Second Xiangya Hospital, Central South University, Changsha, Hunan, China.
  • Sun L; Hunan Key Laboratory of Kidney Disease and Blood Purification, Changsha, Hunan, China.
Ann Surg Oncol ; 31(6): 3894-3905, 2024 Jun.
Article em En | MEDLINE | ID: mdl-38494564
ABSTRACT

OBJECTIVE:

The objective of our study was to integrate the efficacy results of post-nephrectomy adjuvant therapies in renal cell carcinoma (RCC) patients with risk of recurrence, and attempt to determine the optimal intervention choice.

METHODS:

We performed standard meta-analysis procedures in compliance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. The PubMed, Embase, and Cochrane Library databases were searched from inception to 22 September 2022. Randomized controlled trials reporting overall survival (OS) or disease-free survival (DFS) of adjuvant therapies, including immune checkpoint inhibitors (ICIs) and targeted therapies, in adult post-nephrectomy RCC patients were eligible for inclusion.

RESULTS:

Seven studies involving 7548 participants were included in our analyses. In contrast with placebo, DFS benefit with ICIs was only observed in female RCC patients and RCC patients with high programmed death-ligand 1 (PD-L1) expression (≥ 1%), sarcomatoid features, and M0 intermediate-high risk. Network meta-analyses demonstrated that pembrolizumab exhibited both DFS and OS benefit compared with placebo, sunitinib, sorafenib, and girentuximab, and only DFS benefit compared with atezolizumab and nivolumab plus ipilimumab.

CONCLUSIONS:

Our results suggest that post-nephrectomy RCC patients with sarcomatoid differentiation and high PD-L1 expression were more responsive to ICIs. Furthermore, pembrolizumab monotherapy exhibited superior DFS and OS results over other adjuvant therapies.
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Texto completo: 1 Base de dados: MEDLINE Assunto principal: Carcinoma de Células Renais / Neoplasias Renais / Nefrectomia Limite: Humans Idioma: En Ano de publicação: 2024 Tipo de documento: Article

Texto completo: 1 Base de dados: MEDLINE Assunto principal: Carcinoma de Células Renais / Neoplasias Renais / Nefrectomia Limite: Humans Idioma: En Ano de publicação: 2024 Tipo de documento: Article