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Annals of Surgical Oncology

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17-03-2024 | Kidney Cancer | Urologic Oncology

Efficacy Assessment of Post-nephrectomy Adjuvant Therapies in Patients with Renal Cell Carcinoma

Authors: Kaiyue Ding, MD, Zhixuan Yang, MD, Danyan Zhang, MD, Lin Sun, MD, PhD

Published in: Annals of Surgical Oncology | Issue 6/2024

Abstract

Objective

The objective of our study was to integrate the efficacy results of post-nephrectomy adjuvant therapies in renal cell carcinoma (RCC) patients with risk of recurrence, and attempt to determine the optimal intervention choice.

Methods

We performed standard meta-analysis procedures in compliance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. The PubMed, Embase, and Cochrane Library databases were searched from inception to 22 September 2022. Randomized controlled trials reporting overall survival (OS) or disease-free survival (DFS) of adjuvant therapies, including immune checkpoint inhibitors (ICIs) and targeted therapies, in adult post-nephrectomy RCC patients were eligible for inclusion.

Results

Seven studies involving 7548 participants were included in our analyses. In contrast with placebo, DFS benefit with ICIs was only observed in female RCC patients and RCC patients with high programmed death-ligand 1 (PD-L1) expression (≥ 1%), sarcomatoid features, and M0 intermediate–high risk. Network meta-analyses demonstrated that pembrolizumab exhibited both DFS and OS benefit compared with placebo, sunitinib, sorafenib, and girentuximab, and only DFS benefit compared with atezolizumab and nivolumab plus ipilimumab.

Conclusions

Our results suggest that post-nephrectomy RCC patients with sarcomatoid differentiation and high PD-L1 expression were more responsive to ICIs. Furthermore, pembrolizumab monotherapy exhibited superior DFS and OS results over other adjuvant therapies.

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Title: Efficacy Assessment of Post-nephrectomy Adjuvant Therapies in Patients with Renal Cell Carcinoma
Authors: Kaiyue Ding, MD
Zhixuan Yang, MD
Danyan Zhang, MD
Lin Sun, MD, PhD
Publication date: 17-03-2024
Publisher: Springer International Publishing
Keywords: Kidney Cancer
Kidney Cancer
Kidney Cancer
Nephrectomy
Nephrectomy
Nephrectomy
Checkpoint Inhibitors
Sunitinib
Sorafenib
Targeted Therapy
Published in: Annals of Surgical Oncology / Issue 6/2024
Print ISSN: 1068-9265
Electronic ISSN: 1534-4681
DOI: https://doi.org/10.1245/s10434-024-15121-2

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Efficacy Assessment of Post-nephrectomy Adjuvant Therapies in Patients with Renal Cell Carcinoma

Abstract

Objective

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Objective

Methods

Results

Conclusions

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