Evidence map›Paper›PMID 34690032›Full record

SynthesisUrologic oncology2022

Association between prior nephrectomy and efficacy of immune checkpoint inhibitor therapy in metastatic renal cell carcinoma - A systematic review and meta-analysis.

Raj Satkunasivam, Jonathan Ca Guzman, Zachary Klaassen, Mary E Hall, Amy N Luckenbaugh, Kelvin Lim, Aaron A Laviana, Antonio P DeRosa, Kathryn E Beckermann, Brian Rini and 1 more

Open access · greenAbstract readMeta-AnalysisSystematic Review
In one paragraph

Synthesis in Urologic oncology, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
0.4field-weighted citation impact, top 34% 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

3 citing papers in PubMed, 4 citations in OpenAlex.

  1. Trial
  2. Review
  3. 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

11 authors at 5 institutions in 1 country.

Raj SatkunasivamDepartment of Urology and Center for Outcomes Research, Houston Methodist Hospital, Houston, Taxas. Electronic address: raj.satkunasivam@gmail.com.
Jonathan Ca GuzmanDepartment of Urology and Center for Outcomes Research, Houston Methodist Hospital, Houston, Taxas.
Zachary KlaassenDepartment of Surgery, Division of Urology, Medical College of Georgia at Augusta University, Augusta, Georgia; Georgia Cancer Center - Augusta University, Augusta, Georgia.
Mary E HallDepartment of Urology, Vanderbilt University Medical Center, Nashville, Tennessee.
Amy N LuckenbaughDepartment of Urology, Vanderbilt University Medical Center, Nashville, Tennessee.
Kelvin LimDepartment of Urology and Center for Outcomes Research, Houston Methodist Hospital, Houston, Taxas.
Aaron A LavianaDepartment of Surgery & Perioperative Medicine, The University of Texas at Austin Dell Medical School, Austin, Taxas.
Antonio P DeRosaMeyer Cancer Center's Office of Community Outreach and Engagement, Weill Cornell Medicine, New York, New York.
Kathryn E BeckermannDepartment of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee.
Brian RiniDepartment of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee.
Christopher Jd WallisDepartment of Urology, Vanderbilt University Medical Center, Nashville, Tennessee.
Vanderbilt University Medical Center · USHouston Methodist · USAugusta University · USCornell University · USThe University of Texas at Austin · US

Funding

Vanderbilt Clinical Oncology Research Career Development ProgramK12CA090625 · NCI · VANDERBILT UNIVERSITY MEDICAL CENTER · PI Debra L. Friedman, Paula Jill Hurley · 2001 to 2026
$16.9M
NCI NIH HHS K12 CA090625
6 · The paper itself

Abstract

backgroundImmune checkpoint-inhibitor (ICI)-based therapy is the standard of care for first-line treatment of metastatic renal cell carcinoma (mRCC). It is unclear whether prior removal of the primary tumor influences the efficacy of these treatments. We performed a systematic review and meta-analysis of studies of first-line ICI in mRCC to determine whether the efficacy of ICI-therapy, compared to sunitinib, is altered based on receipt of prior nephrectomy.

methodsWe systematically reviewed studies indexed in MEDLINE (PubMed), Embase, and Scopus and conference abstracts from relevant medical societies as of August 2020 to identify randomized clinical trials assessing first-line immunotherapy-based regimes in mRCC. Studies were included if overall survival (OS) and progression-free survival (PFS) outcomes were reported with data stratified by nephrectomy status. We pooled hazard ratios (HRs) stratified by nephrectomy status and performed random effects meta-analysis to assess the null hypothesis of no difference in the survival advantage of immunotherapy-based regimes based on nephrectomy status, while accounting for study level correlations.

resultsAmong 6 randomized clinical trials involving 5,121 patients, 3,968 (77%) had undergone prior nephrectomy. We found an overall survival benefit for immunotherapy-based regimes, compared to sunitinib, among both patients who had undergone nephrectomy (HR 0.75, 95% CI 0.63 -0.88) and those who had not (HR 0.74, 95% CI 0.59 -0.92), without evidence of difference based on nephrectomy history (P = 0.70; I

conclusionsThese clinical data suggest that prior nephrectomy does not affect the efficacy of ICI-based regimens in mRCC relative to sunitinib.

Indexed as

Carcinoma, Renal CellHumansImmune Checkpoint InhibitorsImmunotherapyKidney NeoplasmsMaleNeoplasm MetastasisNephrectomyImmune Checkpoint InhibitorsImmunotherapyNephrectomyRenal cell carcinoma

Identifiers

PMID34690032
PMCPMC10189418
OpenAlexW3209813774

What OpenQuestion holds

Textmetadata
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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.