Fahad Quhal1,2, Keiichiro Mori1,3, Harun Fajkovic1, Mesut Remzi1, Shahrokh F Shariat1,4,5,6,7,8,9,4, Manuela Schmidinger1. 1. Department of Urology, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria. 2. Department of Urology, King Fahad Specialist Hospital, Dammam, Saudi Arabia. 3. Department of Urology, Jikei University School of Medicine, Tokyo, Japan. 4. Institute for Urology and Reproductive Health, Sechenov University, Moscow, Russia. 5. Division of Urology, Hourani Center for Applied Scientific Research, Al-Ahliyya Amman University, Amman, Jordan. 6. Department of Urology, University of Texas Southwestern Medical Center, Dallas, TX, USA. 7. Department of Urology, Second Faculty of Medicine, Charles University, Prague, Czech Republic. 8. Department of Urology, Weill Cornell Medical College, New York, NY, USA. 9. Karl Landsteiner Institute of Urology and Andrology, Vienna, Austria.
Abstract
PURPOSE OF REVIEW: To perform indirect comparisons of efficacy and safety of first-line immune checkpoint inhibitor (ICI)-based combination therapies for renal cell carcinoma with sarcomatoid features (sRCC). RECENT FINDINGS: Five trials were included in our network meta-analyses comprising 568 patients. The combinations nivolumab plus ipilimumab and nivolumab plus cabozantinib achieved significant improvement of progression-free survival (PFS), overall survival (OS), and objective response rates (ORR). Nivolumab plus ipilimumab was associated with the highest likelihood of achieving a complete response. All the included combinations significantly improved PFS and ORR. The combinations of pembrolizumab plus axitinib did not show a statistically significant association with OS. Nivolumab plus cabozantinib had the highest likelihood of improving PFS and OS. SUMMARY: Our network meta-analysis demonstrates that sRCC are responsive to immune-based combinations. The dual ICI with nivolumab plus ipilimumab improved all efficacy outcomes and achieved the highest complete response rates (CRR). Although the association of nivolumab plus cabozantinib with CRR was not statistically significant, this combination demonstrated the highest likelihood of PFS and OS improvements.
PURPOSE OF REVIEW: To perform indirect comparisons of efficacy and safety of first-line immune checkpoint inhibitor (ICI)-based combination therapies for renal cell carcinoma with sarcomatoid features (sRCC). RECENT FINDINGS: Five trials were included in our network meta-analyses comprising 568 patients. The combinations nivolumab plus ipilimumab and nivolumab plus cabozantinib achieved significant improvement of progression-free survival (PFS), overall survival (OS), and objective response rates (ORR). Nivolumab plus ipilimumab was associated with the highest likelihood of achieving a complete response. All the included combinations significantly improved PFS and ORR. The combinations of pembrolizumab plus axitinib did not show a statistically significant association with OS. Nivolumab plus cabozantinib had the highest likelihood of improving PFS and OS. SUMMARY: Our network meta-analysis demonstrates that sRCC are responsive to immune-based combinations. The dual ICI with nivolumab plus ipilimumab improved all efficacy outcomes and achieved the highest complete response rates (CRR). Although the association of nivolumab plus cabozantinib with CRR was not statistically significant, this combination demonstrated the highest likelihood of PFS and OS improvements.
Authors: Sara Elena Rebuzzi; Alessio Signori; Marco Stellato; Daniele Santini; Marco Maruzzo; Ugo De Giorgi; Paolo Pedrazzoli; Luca Galli; Paolo Andrea Zucali; Emanuela Fantinel; Claudia Carella; Giuseppe Procopio; Michele Milella; Francesco Boccardo; Lucia Fratino; Roberto Sabbatini; Riccardo Ricotta; Stefano Panni; Francesco Massari; Mariella Sorarù; Matteo Santoni; Alessio Cortellini; Veronica Prati; Hector Josè Soto Parra; Francesco Atzori; Marilena Di Napoli; Orazio Caffo; Marco Messina; Franco Morelli; Giuseppe Prati; Franco Nolè; Francesca Vignani; Alessia Cavo; Giandomenico Roviello; Miguel Angel Llaja Obispo; Camillo Porta; Sebastiano Buti; Giuseppe Fornarini; Giuseppe Luigi Banna Journal: Front Oncol Date: 2022-09-23 Impact factor: 5.738