The clinical significance of routine risk categorization in metastatic renal cell carcinoma and its impact on treatment decision-making: a systematic review.
Shouki BazarbashiAbdullah AlsharmFaisal AzamHazem El AshryJamal ZekriPublished in: Future oncology (London, England) (2020)
Aim: To analyze responses to first-line metastatic renal cell carcinoma (mRCC) treatment stratified by risk criteria. Patients & methods: Clinical trials and observational studies of patients aged ≥18 years, published January 2005-May 2019, were identified via Ovid from MEDLINE, EMBASE, the Cochrane Central Trials Register and the Cochrane Database of Systematic Reviews. Data extracted included progression-free survival (PFS), overall survival (OS) and objective response rate (ORR). Results: 47/1269 articles met eligibility criteria. Most studies stratified patients by International Metastatic RCC Database Consortium (n = 19) or Memorial Sloan Kettering Cancer Center (n = 21). PFS, OS and ORR varied according to risk group. Conclusion: Pembrolizumab + axitinib, ipilimumab + nivolumab and avelumab + axitinib were most effective across all risk groups. Favorable-risk patients benefit from sunitinib treatment.
Keyphrases
- end stage renal disease
- metastatic renal cell carcinoma
- ejection fraction
- newly diagnosed
- chronic kidney disease
- clinical trial
- prognostic factors
- emergency department
- systematic review
- small cell lung cancer
- squamous cell carcinoma
- randomized controlled trial
- free survival
- patient reported outcomes
- lymph node metastasis
- renal cell carcinoma
- big data
- smoking cessation
- phase ii