SynthesisJAMA network open2021
Use of Second-line Immunotherapy in Control Arms of Randomized Clinical Trials in Kidney Cancer: A Systematic Review.
Synthesis in JAMA network open, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.
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.
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.
Who cites it
3 citing papers in PubMed, 8 citations in OpenAlex.
- Transportability of nonlocal real-world evidence and its relevance to health technology assessment: a primer.Journal of comparative effectiveness research · 2025Review
- Article
- Hard-wired biases in trials: maintenance azacitidine in patients with acute myeloid leukemia and framework for future trials.Blood advances · 2022Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
3 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Importance: Immunotherapy (anti-programmed death ligand 1 antibodies) is associated with improved survival rates in advanced kidney cell carcinoma (KCC) after progression on first-line tyrosine kinase inhibitor (TKI) treatment. It is unknown whether and to what degree patients in the control arm receive postprotocol immunotherapy in trials comparing combination immunotherapy regimens with TKI in first-line advanced KCC. Objective: To characterize the proportion of patients in the control arm who received postprotocol immunotherapy in trials comparing combination immunotherapy regimens with TKI in first-line advanced KCC. Evidence Review: A search of PubMed was conducted to identify randomized clinical trials of combination immunotherapy compared with TKI in first-line advanced KCC between January 1, 2015, and February 28, 2021. Combination immunotherapy was defined as an anti-programmed death ligand 1 agent and an additional agent. Search terms included renal cell cancer and first-line and were filtered by the type clinical trial. All English-language trials of combination immunotherapy compared with a TKI were included. The trials and their protocols and supplements were analyzed to determine the proportion of patients in the control arm receiving postprotocol immunotherapy. Findings: A total of 106 articles met search criteria and were screened. A total of 6 trials and 3 published updates of trial results were included in the systematic review. Of 2565 patients assigned to control arm groups, 2069 (81%) were no longer on TKI at last data cutoff. Of patients in the control arm who discontinued TKI, 932 (45%) received postprotocol immunotherapy. Of patients in the control arm receiving any type of postprotocol therapy, 66.4% received immunotherapy. Conclusions and Relevance: This systematic review found that the proportion of patients in the control arm receiving postprotocol immunotherapy is low in randomized clinical trials of first-line combination immunotherapy regimens for advanced KCC. Appropriate use of postprotocol therapy is essential to answering the question of whether a combination or sequential treatment strategy with immunotherapy is superior.
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Registered trials
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.