You have accessJournal of UrologyKidney Cancer: Advanced (including Drug Therapy) II (PD40)1 Sep 2021PD40-07 CLINICAL OUTCOMES AND ADVERSE EVENTS AFTER FIRST-LINE TREATMENT IN METASTATIC RENAL CELL CARCINOMA: A SYSTEMATIC REVIEW AND NETWORK META-ANALYSIS Luigi Nocera, Pierre Karakiewicz, Mike Wenzel, Shahrokh Shariat, Fred Saad, Felix Chun, Alberto Briganti, Anil Kapoor, Aly-Khan Lalani, Alberto Martini, Alessandro Larcher, Luigi Candela, Antony Pellegrino, Giuseppe Fallara, Gianfranco Baiamonte, Cristina Giancristofaro, Roberto Bertini, Andrea Necchi, Francesco Montorsi, and Umberto Capitanio Luigi NoceraLuigi Nocera More articles by this author , Pierre KarakiewiczPierre Karakiewicz More articles by this author , Mike WenzelMike Wenzel More articles by this author , Shahrokh ShariatShahrokh Shariat More articles by this author , Fred SaadFred Saad More articles by this author , Felix ChunFelix Chun More articles by this author , Alberto BrigantiAlberto Briganti More articles by this author , Anil KapoorAnil Kapoor More articles by this author , Aly-Khan LalaniAly-Khan Lalani More articles by this author , Alberto MartiniAlberto Martini More articles by this author , Alessandro LarcherAlessandro Larcher More articles by this author , Luigi CandelaLuigi Candela More articles by this author , Antony PellegrinoAntony Pellegrino More articles by this author , Giuseppe FallaraGiuseppe Fallara More articles by this author , Gianfranco BaiamonteGianfranco Baiamonte More articles by this author , Cristina GiancristofaroCristina Giancristofaro More articles by this author , Roberto BertiniRoberto Bertini More articles by this author , Andrea NecchiAndrea Necchi More articles by this author , Francesco MontorsiFrancesco Montorsi More articles by this author , and Umberto CapitanioUmberto Capitanio More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000002050.07AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Four recent first line clinical trials that leverage immune-oncology agents have demonstrated an overall survival benefit relative to sunitinib. However, formal network meta-analysis-based comparisons have not yet been presented. We present these comparisons in this analysis. We aimed to provide comparisons of overall survival (OS), progression-free survival (PFS), objective response rates (ORR) and adverse events (AEs). METHODS: Pubmed database was searched for studies indexed from 2016 through 2021, including conference abstracts. The systematic search was supplemented by hand search. Only phase III randomized clinical trials with proven OS benefit, relative to sunitinib, were included: CheckMate 214 (nivolumab plus ipilimumab), KEYNOTE-426 (pembrolizumab plus axitinib), CheckMate 9ER (nivolumab plus cabozantinib) and KEYNOTE-581 (lenvatinib plus permbrolizumab). OS represented the primary outcome of the study. PFS, ORR and AEs represented secondary outcomes. RESULTS: Overall, 3,320 patients from four trials were included. Regarding OS, nivolumab plus cabozantinib ranked first, followed by lenvatinib plus pembrolizumab, pembolizumab plus axitinib and nivolumab plus ipilimumab, in that order. Conversely, regarding PFS, lenvatinib plus pembrolizumab ranked first, followed by nivolumab plus cabozantinib, pembrolizumab plus axitinib and nivolumab plus ipilimumab. Similarly, lenvatinib plus pembrolizumab ranked first with respect to ORR, followed by nivolumab plus cabozantinib, pembrolizumab plus axitinib and nivolumab plus ipilimumab, in that order. Finally, nivolumab plus ipilimumab ranked first with respect to lowest grade 3+ adverse events, followed by pembrolizumab plus axitinib, nivolumab plus cabozantinib and lanvatinib plus pembrolizumab. Important differences in follow-up duration, risk group composition and nephrectomy rates distinguish the four studies. CONCLUSIONS: Nivolumab plus cabozantinib combination may provide the most favorable OS. Conversely, lenvatinib plus pembrolizumab may provide the most favorable PFS and ORRs, while nivolumab plus ipilimumab the lowest toxicity. However, important population differences may potentially undermine the generalizability and the robustness of these findings. Source of Funding: None © 2021 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 206Issue Supplement 3September 2021Page: e676-e677 Advertisement Copyright & Permissions© 2021 by American Urological Association Education and Research, Inc.MetricsAuthor Information Luigi Nocera More articles by this author Pierre Karakiewicz More articles by this author Mike Wenzel More articles by this author Shahrokh Shariat More articles by this author Fred Saad More articles by this author Felix Chun More articles by this author Alberto Briganti More articles by this author Anil Kapoor More articles by this author Aly-Khan Lalani More articles by this author Alberto Martini More articles by this author Alessandro Larcher More articles by this author Luigi Candela More articles by this author Antony Pellegrino More articles by this author Giuseppe Fallara More articles by this author Gianfranco Baiamonte More articles by this author Cristina Giancristofaro More articles by this author Roberto Bertini More articles by this author Andrea Necchi More articles by this author Francesco Montorsi More articles by this author Umberto Capitanio More articles by this author Expand All Advertisement Loading ...
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