Evidence map›Paper›PMID 25686740›Full record

SynthesisInternational urology and nephrology2015

Therapeutic effects and associated adverse events of first-line treatments of advanced renal cell carcinoma (RCC): a meta-analysis.

Lei Wang, Ling Ma, Xinli Wang, Bing Li, Shan Guo, Qingdong Qiao

Abstract readMeta-AnalysisReview
PubMed Publisher
In one paragraph

Synthesis in International urology and nephrology, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers, 3 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed, 3 pooled it
1.0field-weighted citation impact, top 22% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

5 citing papers in PubMed, 3 syntheses or guidelines pooled it, 6 citations in OpenAlex.

  1. Pooled it
  2. Pooled it
  3. Pooled it
  4. Article
  5. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors at 1 institution in 1 country.

Lei WangDepartment of No. 1 Urology, Xinxiang Central Hospital, No. 56, Jinsui Road, Xinxiang, 453000, Henan, China.
Ling Ma
Xinli Wang
Bing Li
Shan Guo
Qingdong Qiao
Xinxiang Central Hospital · CN

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeTo compare the therapeutic effects and adverse events (AE) of current first-line treatments of advanced RCC, including sorafenib, sunitinib, temsirolimus, and the combination of bevacizumab and IFN-α.

methodsWe performed a meta-analysis of randomized controlled trials of the effectiveness of the five treatments among patients with advanced RCC. The data of progressive disease, objective response rate (ORR), disease control rate (DCR), grade 3/4 AE, progression-free survival (PFS), and overall survival (OS) were extracted to assess therapeutic effects, toxicity, and prognosis, respectively.

resultsTwo studies that assessed the combination of bevacizumab with IFN α (n = 1381), one sunitinib (n = 750), one sorafenib (n = 189) and one temsirolimus (n = 416) were included. Sorafenib, sunitinib, temsirolimus (R = 0.35, 95% confidence interval [CI] 0.26-0.48, P < 0.01), and the combination of bevacizumab with IFN (R = 0.64, 95% CI 0.42-0.99, P = 0.04) were more effective in controlling tumor progression than IFN. Sorafenib, sunitinib, and temsirolimus do not own advantage in ORR compared with IFN (R = 2.06, 95% CI 0.53-7.95, P = 0.30), but combination of bevacizumab with IFN showed better results in ORR than IFN (R = 2.56, 95% CI 1.91-3.42, P < 0.01). Sorafenib, sunitinib, temsirolimus (R = 2.90, 95% CI 2.23-3.78, P < 0.01), and combination of bevacizumab with IFN (R = 2.14, 95% CI 1.65-2.78, P < 0.01) were more effective than IFN in DCR. Sorafenib, sunitinib, and temsirolimus had similar rate of grade 3/4 AE as IFN (R = 1.21, 95% CI 0.96-1.51, P = 0.10). Combined use of bevacizumab and IFN is associated with higher frequency of the AE (R = 2.09, 95% CI 1.66-2.63, P < 0.01). Sorafenib and sunitinib had similar median PFS (R = 0.67, 95% CI 0.42-1.08, P = 0.10); temsirolimus had longer median OS (R = 0.82, 95% CI 0.67-1.00, P = 0.049) as IFN. Combined use of bevacizumab and IFN had longer median PFS (R = 0.68, 95% CI 0.60-0.76, P < 0.01) and OS (R = 0.86, 95% CI 0.76-0.97, P = 0.01) than IFN.

conclusionSorafenib, sunitinib, temsirolimus, and the combination of bevacizumab with IFN are more effective in stabilizing disease. Combined use of bevacizumab and IFN is better than sorafenib, sunitinib, and temsirolimus in ORR, PFS, and OS, but associated with higher level of AE.

Indexed as

Antineoplastic AgentsCarcinoma, Renal CellDisease-Free SurvivalHumansKidney NeoplasmsNeoplasm StagingAntineoplastic Agents

Identifiers

PMID25686740
OpenAlexW1998776115

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.