Dual Therapy Does Not Improve Overall Survival In Advanced Renal Cell Carcinoma Patients, Study Finds

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.

Dual Therapy Does Not Improve Overall Survival In Advanced Renal Cell Carcinoma Patients, Study Finds
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

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