Journal article
Adjuvant immunotherapy in renal cell carcinoma: A living systematic review and network meta-analysis (NMA)
Journal of clinical oncology, Vol.41(6_suppl), pp.694-694
02/20/2023
DOI: 10.1200/JCO.2023.41.6_suppl.694
Abstract
694 Background: The treatment landscape of localized renal cell carcinoma (RCC) is rapidly evolving. Recent trials have demonstrated contrasting efficacy with adjuvant immunotherapy. Therefore, we sought to assess the mixed treatment comparisons among different adjuvant treatment options using updated data from trials and quantified the absolute effect with these treatments stratified by risk categories. Methods: This living network meta-analysis was conducted using the living interactive evidence (LIvE) synthesis framework. We used stratified baseline risks of disease progression from observational data and at 5, 10, 15 years from the Leibovich risk stratification system (based on risk scores ranging from 0 to ≥15). Corresponding intervention risks were then approximated using relative effect estimates (from NMA) and baseline risks. The difference between CIRs and baseline risks were calculated to present absolute risk differences in each risk category. Results: This NMA included eight RCTs with 8480 participants and seven unique treatment options. Pembrolizumab (pembro; rank 1) was associated with improved disease-free survival (DFS) when compared to atezolizumab (atezo; rank 6; hazard ratio: 0.68; 0.49;0.93), and nivolumab-ipilimumab (nivoipi; rank 5; 0.68; 0.48-0.97). However, no statistically significant difference was observed between pembro and atezo for overall survival (0.53; 0.28-1.01). Survival data for nivoIpi was not reported. No new statistically significant differences were observed since last update. The absolute benefit of atezo and nivoipi was minimal with higher T and N patients (Table). The results were similar with increasing Leibovich risk scores. Conclusions: Current evidence favors the use of a risk adapted approach when offering adjuvant immunotherapy. Adjuvant pembrolizumab remains a preferred treatment in patients with RCC who underwent nephrectomy. [Table: see text]
Details
- Title: Subtitle
- Adjuvant immunotherapy in renal cell carcinoma: A living systematic review and network meta-analysis (NMA)
- Creators
- Qurat Ul Ain Riaz Sipra - University of ArizonaIrbaz Bin Riaz - Dana-Farber Cancer Institute, Boston, MASyed Arsalan Ahmed Naqvi - Mayo Clinic HospitalHuan He - Mayo ClinicRabbia Siddiqi - Dow University of Health SciencesMahnoor Islam - Dow University of Health SciencesNoureen Asghar - Dow University of Health SciencesWaleed Ikram - Mayo Clinic HospitalWenxin (Vincent) Xu - Dana-Farber Cancer InstituteParminder Singh - Mayo Clinic HospitalThai Huu Ho - Mayo Clinic in ArizonaMehmet Asim Bilen - Emory UniversityYousef Zakharia - University of IowaAlan Haruo Bryce - Mayo Clinic Hospital
- Resource Type
- Journal article
- Publication Details
- Journal of clinical oncology, Vol.41(6_suppl), pp.694-694
- DOI
- 10.1200/JCO.2023.41.6_suppl.694
- ISSN
- 0732-183X
- eISSN
- 1527-7755
- Grant note
- name: None.
- Language
- English
- Date published
- 02/20/2023
- Academic Unit
- Internal Medicine; Hematology, Oncology, and Blood & Marrow Transplantation
- Record Identifier
- 9984548266602771
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