+ Site Statistics
+ Search Articles
+ PDF Full Text Service
How our service works
Request PDF Full Text
+ Follow Us
Follow on Facebook
Follow on Twitter
Follow on LinkedIn
+ Subscribe to Site Feeds
Most Shared
PDF Full Text
+ Translate
+ Recently Requested

Adjuvant Tyrosine Kinase Inhibitors in Treatment of Renal Cell Carcinoma: A Meta-Analysis of Available Clinical Trials

Adjuvant Tyrosine Kinase Inhibitors in Treatment of Renal Cell Carcinoma: A Meta-Analysis of Available Clinical Trials

Clinical Genitourinary Cancer 2019

Although tyrosine kinase inhibitors (TKIs) are widely used in the metastatic setting, they have shown more limited effectiveness in the adjuvant setting. Despite multiple clinical trials, there has been no improvement in overall survival (OS) with the use of these agents as adjuvant therapy, and conflicting data on disease-free survival (DFS). We carried out a meta-analysis of available phase III randomized clinical trials on adjuvant TKIs in clear-cell renal cell carcinoma (RCC). Primary end points of our study were the effect of adjuvant TKIs on OS and DFS in the overall population. Furthermore, we investigated if use of adjuvant TKIs resulted in improved DFS among patients with different risk of tumor relapse. Higher-risk patients were patients with 1 or more of the following features: positive nodes (N+), T4 tumors and T3 tumors, with higher Fuhrman grades (3-4). We adopted Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines to carry out our study. In the overall population, the pooled hazard ratio (HR) of OS and DFS was 0.89 (95% confidence interval [CI], 0.76-1.04) and 0.84 (95% CI, 0.76-0.93), respectively. In the low- and high-risk populations, the pooled DFS HR was 0.98 (95% CI, 0.82-1.17) and 0.85 (95% CI, 0.75-0.97), respectively. Adjuvant use of TKIs do not appear to provide a statistically significant OS benefit. However, a benefit in DFS has been observed in overall and high-risk populations, suggesting that better selection of patients might be important for the evaluation of adjuvant therapies in RCC.

Please choose payment method:

(PDF emailed within 0-6 h: $19.90)

Accession: 066446856

Download citation: RISBibTeXText

PMID: 30704796

DOI: 10.1016/j.clgc.2018.12.011

Related references

Fatigue with vascular endothelial growth factor receptor tyrosine kinase inhibitors and mammalian target of rapamycin inhibitors in patients with renal cell carcinoma (RCC) and other malignancies: A meta-analysis of randomized clinical trials. Critical Reviews in Oncology/Hematology 95(2): 251-263, 2016

The merit of tyrosine kinase inhibitors in the adjuvant setting of high-risk renal cell carcinoma: a meta-analysis. Future Oncology 14(9): 829-835, 2018

Efficacy of EGFR Tyrosine Kinase Inhibitors in the Adjuvant Treatment for Operable Non-small Cell Lung Cancer by a Meta-Analysis. Chest 149(6): 1384-1392, 2017

C-reactive protein is a predictor of prognosis in renal cell carcinoma patients receiving tyrosine kinase inhibitors: A meta-analysis. Clinica Chimica Acta; International Journal of Clinical Chemistry 475: 178-187, 2017

Tyrosine kinase inhibitors compared with cytokine therapy for metastatic renal cell carcinoma: overview of recent clinical trials differentiating clinical response and adverse effects. Clinical Genitourinary Cancer 5 Suppl 1: S19-S23, 2007

Risk of Treatment-Related Toxicities from EGFR Tyrosine Kinase Inhibitors: A Meta-analysis of Clinical Trials of Gefitinib, Erlotinib, and Afatinib in Advanced EGFR-Mutated Non-Small Cell Lung Cancer. Journal of Thoracic Oncology 12(4): 633-643, 2016

The Evolution of Nephrectomy and Patient Characteristics in Metastatic Renal Cell Carcinoma Patients Enrolled Into First-Line Tyrosine Kinase Inhibitors Clinical Trials. Clinical Genitourinary Cancer 14(5): 415-419, 2016

Sequential treatment of tyrosine kinase inhibitors and chemotherapy for EGFR-mutated non-small cell lung cancer: a meta-analysis of Phase III trials. Oncotargets and Therapy 6: 1771-1777, 2013

Sequential Treatment of Tyrosine Kinase Inhibitors and Chemotherapy for EGFR-Mutated Non-small Cell Lung Cancer: A Meta-analysis of Phase III Trials. Chest Journal 145(3): 348a-1-348a-2, 2014

First-line therapy in advanced renal cell carcinoma : A randomized phase II study to examine early switch of tyrosine kinase inhibitors to nivolumab compared to continued tyrosine kinase inhibitor therapy in patients with advanced or metastatic renal cell carcinoma and stable disease after three months of treatment (NIVOSWITCH)-AN 38/15 of the AUO. Der Urologe. Ausg. a 56(4): 509-511, 2017

Results of the first trial assessing adjuvant tyrosine kinase inhibitors in renal cell carcinoma do not reASSURE. European Urology 68(3): 542-543, 2016

Acquired Hypothyroidism as a Predictive Marker of Outcome in Patients With Metastatic Renal Cell Carcinoma Treated With Tyrosine Kinase Inhibitors: A Literature-Based Meta-Analysis. Clinical Genitourinary Cancer 13(4): 280-286, 2016

Efficacy and safety of chemotherapy or tyrosine kinase inhibitors combined with bevacizumab versus chemotherapy or tyrosine kinase inhibitors alone in the treatment of non-small cell lung cancer: a systematic review and meta-analysis. Medical Oncology 32(2): 473, 2015

Emergence of BCR-ABL kinase domain mutations associated with newly diagnosed chronic myeloid leukemia: a meta-analysis of clinical trials of tyrosine kinase inhibitors. Journal of Managed Care and Specialty Pharmacy 21(2): 114-122, 2015

Predictive biomarkers for EGFR tyrosine kinase inhibitors in treatment of advanced non-small-cell lung cancer: a systematic review and meta-analysis of randomised controlled trials. Hong Kong Medical Journal 24 Suppl 4(4): 34-37, 2018