mechanism | treatment | Demonstrated benefit and harm | k | | | |
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angiogenesis inhibitors | bevacizumab | versus No demonstrated result for efficacy | 3 trials | meta-analysis | | Trial | control | p<0.05 | harm | NS |
---|
CALGB 90206, 2010 | bevacizumab plus interferon alfa vs interferon alpha | PFS 0.71 [0.61; 0.83] | | OS 0.86 [0.73; 1.01] | AVOREN, 2007 | bevacizumab plus interferon alfa vs interferon alpha | PFS 0.63 [0.52; 0.76] | | OS 0.86 [0.72; 1.03] | Yang, 2003 | bevacizumab vs placebo | | | |
Trial | Treatments | Patients | Method |
---|
CALGB 90206, 2010 | bevacizumab (10 mg/kg intravenously every 2 weeks) plus IFN- (9 million units subcutaneously
three times weekly) (n=369) vs. same dose and schedule of IFN- monotherapy (n=363) | Patients with previously untreated, metastatic clear cell RCC | Parallel groups Sample size: 369/363 Primary endpoint: OS FU duration: | AVOREN, 2007 | bevacizumab (10 mg/kg every 2 weeks) plus IFN (9 MIU subcutaneously three times a week) (n=327) vs. IFN plus placebo (n=322) | patients with previously untreated mRCC | Sample size: 327/322 Primary endpoint: FU duration: | Yang, 2003 | bevacizumab at doses of 3 and 10 mg per kilogram of body weight, given every two weeks (n=76) vs. placebo (n=40) | patients with metastatic renal-cell carcinoma | Parallel groups Sample size: 76/40 Primary endpoint: FU duration: |
|
immune checkpoint inhibition | nivolumab | versus nivolumab + ipilimumab superior to sunitinib in terms of OS in CheckMate-214, 2017 (1L patients) | 2 trials | meta-analysis | | Trial | control | p<0.05 | harm | NS |
---|
Chekmate 025 (Motzer), 2015 | nivolumab vs everolimus | OS 0.73 [0.57; 0.93] median 25.0 mo vs. 19.6 mo | | PFS 0.88 [0.75; 1.03] median 4.6 mo vs. 4.4 mo | CheckMate-214, 2017 | nivolumab + ipilimumab vs sunitinib | OS 0.68 [0.49; 0.95] median not reached vs. 32.9 mo Demonstrated | | PFS 0.82 [0.64; 1.05] median 11.56 mo vs. 8.38 mo |
Trial | Treatments | Patients | Method |
---|
Chekmate 025 (Motzer), 2015 | 3 mg of nivolumab per kilogram of body weight intravenously every 2 weeks (n=-9) vs. 10-mg everolimus tablet orally once daily (n=-9) | patients with advanced clear-cell renal-cell carcinoma for which they had received previous treatment with one or two regimens of antiangiogenic therapy | open-label Parallel groups Sample size: -9/-9 Primary endpoint: OS FU duration: | CheckMate-214, 2017 | nivolumab 3 mg/kg plus ipilimumab 1 mg/kg every 3 weeks for 4 doses followed by Opdivo 3 mg/kg every 2 weeks (n=-9) vs. sunitinib 50 mg once daily for 4 weeks, followed by 2 weeks off before continuation of treatment (n=-9) | intermediate and poor-risk patients previously untreated advanced or metastatic renal cell carcinoma | open-label Parallel groups Sample size: -9/-9 Primary endpoint: ORR, PFS, OS FU duration: phase 3 |
|
multi target TKI | apitolisib | versus No demonstrated result for efficacy | 1 trial | meta-analysis | | Trial | control | p<0.05 | harm | NS |
---|
Powles, 2014 | apitolisib vs everolimus | | | |
Trial | Treatments | Patients | Method |
---|
Powles, 2014 | (n=-9) vs. (n=-9) | | Sample size: -9/-9 Primary endpoint: FU duration: |
|
multi target TKI | axitinib | versus No demonstrated result for efficacy | 2 trials | meta-analysis | | Trial | control | p<0.05 | harm | NS |
---|
AXIS (Rini), 2011 | axitinib vs sorafenib | PFS 0.67 [0.54; 0.81] | | | Qin, 2012 | axitinib vs sorafenib | | | |
Trial | Treatments | Patients | Method |
---|
AXIS (Rini), 2011 | axitinib (n=-9) vs. (n=-9) | second-line therapy in patients with metastatic renal cell cancer | Sample size: -9/-9 Primary endpoint: FU duration: | Qin, 2012 | (n=-9) vs. (n=-9) | | Sample size: -9/-9 Primary endpoint: FU duration: |
|
multi target TKI | cabozantinib | versus No demonstrated result for efficacy | 2 trials | meta-analysis | | Trial | control | p<0.05 | harm | NS |
---|
METEOR, 2015 | cabozantinib vs everolimus | OS 0.67 [0.51; 0.89] PFS 0.58 [0.45; 0.75] | | | CABOSUN, 2017 | cabozantinib vs sunitinib | PFS 0.66 [0.46; 0.95] median 8.2 mo vs. 5.6 mo | | |
Trial | Treatments | Patients | Method |
---|
METEOR, 2015 | cabozantinib at a dose of 60 mg
daily (n=330) vs. everolimus at a dose of 10 mg daily (n=328) | patients with renal-cell carcinoma that had progressed after VEGFR-targeted therapy | open-label Parallel groups Sample size: 330/328 Primary endpoint: PFS FU duration: phase 3 | CABOSUN, 2017 | cabozantinib (60 mg once per day) (n=79) vs. sunitinib (50 mg once per day; 4 weeks on, 2 weeks off). (n=78) | untreated clear cell mRCC and Eastern Cooperative Oncology Group performance status of 0 to 2 and were intermediate or poor risk per International Metastatic Renal Cell Carcinoma Database Consortium criteria | open-label Parallel groups Sample size: 79/78 Primary endpoint: PFS FU duration: phase 2 |
|
multi target TKI | dovitinib | versus No demonstrated result for efficacy | 1 trial | meta-analysis | | Trial | control | p<0.05 | harm | NS |
---|
GOLD | dovitinib vs sorafenib | | | PFS 0.86 [0.72; 1.03] |
Trial | Treatments | Patients | Method |
---|
GOLD | dovitinib (500 mg orally according to a 5-days-on and 2-days-off schedule) (n=284) vs. sorafenib (400 mg orally twice daily) (n=286) | patients with clear cell metastatic renal cell carcinoma who received one previous VEGF-targeted therapy and one previous mTOR inhibitor | open-label Sample size: 284/286 Primary endpoint: FU duration: |
|
multi target TKI | pazopanib | versus No demonstrated result for efficacy | 3 trials | meta-analysis | | Trial | control | p<0.05 | harm | NS |
---|
Sternberg, 2010 | pazopanib vs placebo | PFS 0.46 [0.34; 0.62] | | | VEG105192, 2010 | pazopanib vs placebo | PFS 0.46 [0.34; 0.62] | | OS 0.91 [0.71; 1.16] | COMPARZ, 2013 | pazopanib vs sunitinib | | | OS 0.91 [0.76; 1.08] PFS 1.05 [0.90; 1.22] |
Trial | Treatments | Patients | Method |
---|
Sternberg, 2010 | pazopanib (n=-9) vs. placebo (n=-9) | treatment-naive and cytokine-pretreated patients with advanced renal cell carcinoma | double-blind Parallel groups Sample size: -9/-9 Primary endpoint: PFS FU duration: | VEG105192, 2010 | (n=290) vs. (n=145) | treatment-naive and
cytokine-pretreated patients with advanced renal cell carcinoma | Sample size: 290/145 Primary endpoint: PFS FU duration: | COMPARZ, 2013 | continuous dose of pazopanib (800 mg once daily) (n=557) vs. sunitinib in 6-week cycles (50 mg once daily for 4 weeks, followed by 2 weeks without treatment) (n=553) | patients with clear-cell, metastatic renal-cell carcinoma, first line | Parallel groups Sample size: 557/553 Primary endpoint: PFS FU duration: |
|
multi target TKI | sorafenib | versus No demonstrated result for efficacy | 3 trials | meta-analysis | | Trial | control | p<0.05 | harm | NS |
---|
Escudier, 2009 | sorafenib vs interferon alpha | | | PFS 0.88 [0.61; 1.27] | TARGET, 2007 | sorafenib vs placebo | PFS 0.44 [0.35; 0.55] | | OS 0.88 [0.74; 1.04] | Ratain, 2006 | sorafenib vs placebo | | | |
Trial | Treatments | Patients | Method |
---|
Escudier, 2009 | oral sorafenib 400 mg twice daily (n=97) vs. subcutaneous IFN--2a 9 million U three times weekly (n=92) | patients with untreated, advanced renal cancer. | Parallel groups Sample size: 97/92 Primary endpoint: FU duration: phase 2 | TARGET, 2007 | continuous treatment with oral sorafenib (at a dose of 400 mg twice daily) (n=451) vs. placebo (n=452) | patients with renal-cell carcinoma that was resistant to standard therapy | Parallel groups Sample size: 451/452 Primary endpoint: OS FU duration: | Ratain, 2006 | (n=-9) vs. (n=-9) | patients with metastatic renal cell carcinoma | Sample size: -9/-9 Primary endpoint: FU duration: |
|
multi target TKI | sunitinib | versus No demonstrated result for efficacy | 2 trials | meta-analysis | | Trial | control | p<0.05 | harm | NS |
---|
Motzer, 2007 | sunitinib vs interferon alpha | PFS 0.42 [0.32; 0.55] | | OS 0.82 [0.67; 1.00] | SWITCH | sunitinib vs sorafenib | | | |
Trial | Treatments | Patients | Method |
---|
Motzer, 2007 | repeated 6-week cycles of sunitinib (at a dose of 50 mg given orally once daily for 4 weeks, followed by 2 weeks without treatment) (n=375) vs. interferon alfa (at a dose of 9 MU given subcutaneously three times weekly). (n=375) | patients with previously untreated, metastatic renal-cell carcinoma | Sample size: 375/375 Primary endpoint: PFS FU duration: | SWITCH | (n=-9) vs. (n=-9) | | Sample size: -9/-9 Primary endpoint: FU duration: |
|
multi target TKI | tivozanib | versus No demonstrated result for efficacy | 1 trial | meta-analysis | | Trial | control | p<0.05 | harm | NS |
---|
TIVO-1, 2013 | tivozanib vs sorafenib | PFS 0.80 [0.64; 0.99] | | OS 1.25 [0.95; 1.63] |
Trial | Treatments | Patients | Method |
---|
TIVO-1, 2013 | tivozanib (n=260) vs. sorafenib (n=257) | initial targeted therapy in patients with metastatic renal cell carcinoma | Sample size: 260/257 Primary endpoint: PFS FU duration: |
|