Abstract
ABSTRACTPurpose:To explore the International Metastatic Renal Cell Carcinoma Database Consortium (IMDC) model application for predicting outcome of patients with metastatic renal cell carcinoma using targeted agents.Materials and Methods:We performed a literature review of 989 articles. The selecting process used preferred reporting items for systematic reviews and meta-analyses (PRISMA). All included studies were assessed by Newcastle-Ottawa scale. Results of individual studies were pooled using Stata 14.0 software.Results:A total of 17 articles were included. Most articles provided univariate and multivariate analysis of IMDC model prognosis. Combined HRs were 1.58 (95% CI 1.34-1.82) and 3.74 (95% CI 2.67-4.81) for univariate PFS of intermediate to favorable and poor to favorable respectively. In the category of multivariate PFS, combined HRs were 1.27 (95% CI 0.99-1.56) and 2.29 (95% CI 1.65-2.93) with intermediate to favorable and poor to favorable respectively. Regarding univariate OS, combined HRs were 1.93 (95% CI 1.62-2.24) and 6.25 (95% CI 4.18-8.31) with intermediate to favorable and poor to favorable respectively. With multivariate OS, combined HRs were 1.32 (95%CI 1.04-1.59) and 2.35 (95%CI 1.69-3.01) with intermediate to favorable and poor to favorable respectively.Conclusion:In summary, analysis of currently available clinical evidence indicated that IMDC model could be applied to classify patients with metastatic renal cell carcinoma using targeted agents. However, different types of targeted agents and various areas could affect the accuracy of the model. There was also a difference in predicting patients' PFS and OS.
Highlights
Renal cell carcinoma (RCC) represents approximately 3% of all cancers, with the highest incidence occurring in western countries
Many new therapeutic drugs have emerged, such as immune checkpoint drugs based on PD-1/PDL1 or CTLA4 as representative drugs, targeted agents are still the mainstream drugs for the treatment of metastatic renal cell carcinoma
Inclusion and Exclusion Criteria Inclusion criteria: [1] patients were confirmed with metastatic renal carcinoma pathologically, [2] used targeted agents, [3] provided survival outcome based on International Metastatic Renal Cell Carcinoma Database Consortium (IMDC) model such as progression-free survival (PFS) or overall survival (OS) with hazard ratio (HR) and 95% confidence intervals
Summary
Renal cell carcinoma (RCC) represents approximately 3% of all cancers, with the highest incidence occurring in western countries. During the last two decades, there has been an annual increase of 2% in incidence both worldwide and in Europe, leading to approximately 99, 200 new RCC cases and 39.100 kidney cancer-related deaths within the European Union in 2018 [1]. Many new therapeutic drugs have emerged, such as immune checkpoint drugs based on PD-1/PDL1 or CTLA4 as representative drugs, targeted agents are still the mainstream drugs for the treatment of metastatic renal cell carcinoma. IMDC model was based on prognostic data from populations treated with various targeted drugs [5]. We conducted this study to explore the IMDC model application for predicting outcome in patients with metastatic renal cell carcinoma using targeted agents
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