Evidence map›Paper›PMID 27488984›Full record

ArticleWorld journal of urology2017

Second-line treatment for metastatic clear cell renal cell cancer: experts' consensus algorithms.

C Rothermundt, J von Rappard, T Eisen, B Escudier, V Grünwald, J Larkin, D McDermott, J Oldenburg, C Porta, B Rini and 3 more

Open access · bronzeAbstract readConsensus Statement
PubMed Publisher
In one paragraph

Article in World journal of urology, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
7citing papers in PubMed, 1 pooled it
2.0field-weighted citation impact, top 13% 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

7 citing papers in PubMed, 1 synthesis or guideline pooled it, 11 citations in OpenAlex.

  1. Pooled it
  2. Trial
  3. Article
  4. Article
  5. Review
  6. Article
  7. 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

13 authors at 11 institutions in 7 countries.

C RothermundtDepartment of Haematology and Oncology, Kantonsspital St. Gallen, 9007, St. Gallen, Switzerland. christian.rothermundt@kssg.ch.
J von RappardDepartment of Nephrology, University Hospital Bern, Bern, Switzerland.
T EisenDepartment of Oncology, Cambridge University Hospitals NHS Foundation Cambridge, Cambridge, UK.
B EscudierGustave Roussy, Villejuif, France.
V GrünwaldKlinik für Hämatologie, Hämostaseologie, Onkologie und Stammzelltransplantation, Medizinische Hochschule Hannover, Hannover, Germany.
J LarkinThe Royal Marsden Hospital, London, UK.
D McDermottBeth Israel Deaconess Medical Center, Boston, MA, USA.
J OldenburgDepartment of Medical Oncology, Norwegian Radium Hospital, Oslo, Norway.
C PortaPoliclinico San Matteo Pavia Fondazione IRCCS, Pavia, Italy.
B RiniDepartment of Solid Tumor Oncology, Cleveland Clinic, Cleveland, OH, USA.
M SchmidingerAbteilung für Onkologie, Allgemeines Krankenhaus, Universitätskliniken, Vienna, Austria.
C N SternbergDepartment of Medical Oncology, San Camillo and Forlanini Hospitals, Rome, Italy.
P M PutoraDepartment of Radiation Oncology, Kantonsspital St. Gallen, St. Gallen, Switzerland.
Kantonsspital St. Gallen · CHBeth Israel Deaconess Medical Center · USCambridge University Hospitals NHS Foundation Trust · GBCarlo Forlanini Hospital · ITCleveland Clinic · USInstitut Gustave Roussy · FRMedizinische Hochschule Hannover · DENorwegian Cancer Society · NOPoliclinico San Matteo Fondazione · ITRoyal Marsden Hospital · GBUniversity Hospital of Bern · CH

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundSecond-line systemic treatment options for metastatic clear cell renal cell cancer (mccRCC) are diverse and treatment strategies are variable among experts. Our aim was to investigate the approach for the second-line treatment after first-line therapy with a tyrosine kinase inhibitor (TKI). Recently two phase III trials have demonstrated a potential role for nivolumab (NIV) and cabozantinib (CAB) in this setting. We aimed to estimate the impact of these trials on clinical decision making. MATERIALS AND

methodsEleven international experts were asked to provide their treatment strategies for second-line systemic therapy for mccRCC in the current setting and once NIV and CAB will be approved and available. The treatment strategies were analyzed with the objective consensus approach.

resultsThe analysis of the decision trees revealed everolimus (EVE), axitinib (AXI), NIV and TKI switch (sTKI) as therapeutic options after first-line TKI therapy in the current situation and mostly NIV and CAB in the future setting. The most commonly used criteria for treatment decisions were duration of response, TKI tolerance and zugzwang a composite of several related criteria.

conclusionIn contrast to the first-line setting, recommendations for second-line systemic treatment of mccRCC among experts were not as heterogeneous. The agents mostly used after disease progression on a first-line TKI included: EVE, AXI, NIV and sTKI. In the future setting of NIV and CAB availability, NIV was the most commonly chosen drug, whereas several experts identified situations where CAB would be preferred.

Indexed as

AlgorithmsDecision Support TechniquesAnilidesAntibodies, MonoclonalAntineoplastic AgentsAxitinibCarcinoma, Renal CellConsensusDecision TreesEverolimusHumansImidazolesIndazolesKidney NeoplasmsNivolumabProtein Kinase InhibitorsAnilidesAntibodies, MonoclonalAntineoplastic AgentsAxitinibcabozantinibEverolimusImidazolesIndazolesNivolumabProtein Kinase InhibitorsPyridinesAlgorithmConsensusDiagnostic nodesRenal cell cancer

Identifiers

PMID27488984
OpenAlexW2505393039

What OpenQuestion holds

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Registered trials

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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.