According to the findings of a meta-analysis, dual therapy with immune checkpoint inhibitors (ICIs) does not appear to improve overall survival (OS) in advanced renal cell carcinoma (aRCC) patients with favorable risk when compared to sunitinib alone.
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| Photo: Advanced Renal Cell Carcinoma | InStyleHealth |
Researchers looked for phase II or III randomized
controlled trials testing first-line, palliative-intent dual treatment in aRCC
patients with a good prognosis. They found seven studies with a total of 1,214
patients to include in the meta-analysis.
There was no significant difference in OS between the
combined treatment and sunitinib monotherapy groups (hazard ratio [HR], 0.96,
95 percent confidence interval [CI], 0.73–1.26; p=0.79), according to pooled
data generated using an inverse-variance with random-effects model.
A sensitivity analysis that excluded ICI–ICI
combination regimens yielded the same results, with no OS advantage (HR, 0.99,
95 percent CI, 0.69–1.43; p=0.96).
In the same way, dual therapy had no effect on
progression-free survival in the favorable-risk group (HR, 0.75, 95 percent CI,
0.50–1.13; p=0.17). When the ICI-ICI regimen was removed from the equation, it
exhibited some benefit (HR, 0.63, 95 percent CI, 0.50–0.79; p0.001).
According to the researchers, a lengthier follow-up is
required to conclusively discover any potential OS improvement. Prior to
starting dual therapy in aRCC patients with an acceptable risk, other
management alternatives must be carefully evaluated and discussed.
Source: Urology 2021;doi:10.1016/j.urology.2021.08.023