Quantifying absolute benefit for adjuvant treatment options in renal cell carcinoma: A living interactive systematic review and network meta-analysis

Irbaz Bin Riaz, Qurat Ul Ain Riaz Sipra, Syed Arsalan Ahmed Naqvi, Huan He, Rabbia Siddiqi, Mahnoor Islam, Noureen Asghar, Waleed Ikram, Wenxin Xu, Hongfong Liu, Parminder Singh, Thai Huu Ho, Mehmet Asim Bilen, Yousef Zakharia, Alan Haruo Bryce, Mohammad Hassan Murad

Research output: Contribution to journalReview articlepeer-review

Abstract

Objective: To assess comparative effectiveness of adjuvant therapies for renal cell carcinoma and quantify the absolute benefit of adjuvant treatments by clinicopathological risk groups. Methods: This ‘living’ review was conducted using Living Interactive Evidence (LIvE) synthesis framework. Results: The ‘living’ results are available on an interactive website. This network meta-analysis, including six RCTs with 7525 participants, showed that pembrolizumab (rank 1) significantly improved disease-free survival and overall survival compared with sunitinib but not when compared to pazopanib, and axitinib. The risk of treatment-related grade 3 or higher adverse events was increased with pembrolizumab as compared to placebo and axitinib but not when compared to sunitinib. The absolute benefit of adjuvant pembrolizumab increases substantially with larger tumor size, nodal positivity and higher Leibovich scores. Conclusion: Current evidence suggests that pembrolizumab delays disease progression compared to sunitinib. A risk-adapted strategy should be used in patients undergoing consideration for treatment with adjuvant pembrolizumab.

Original languageEnglish (US)
Article number103706
JournalCritical Reviews in Oncology/Hematology
Volume175
DOIs
StatePublished - Jul 2022

Keywords

  • Baseline risk
  • Immunotherapy
  • Living evidence
  • Pembrolizumab
  • Renal cell carcinoma

ASJC Scopus subject areas

  • Hematology
  • Oncology

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