ArticleTherapeutic advances in medical oncology2025
Unveiling the best immune checkpoint inhibitor-based therapy for metastatic renal cell carcinoma in the first-line setting: an updated systematic review and Bayesian network analysis.
Article in Therapeutic advances in medical oncology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers, 2 of them syntheses that pooled it.
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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.
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Who cites it
6 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Real-World Comparative Effectiveness and Safety of Immune Checkpoint Inhibitors in Advanced Renal Cell Carcinoma: A Systematic Review.Targeted oncology · 2026Pooled it
- Time-Dependent Comparative Effectiveness of First-Line Treatment for Metastatic Clear Cell Renal Cell Carcinoma: A Restricted Mean Survival Time-Based Network Meta-analysis.Targeted oncology · 2026Pooled it
- Rethinking Advanced Renal Cell Carcinoma: Integrative Genomics, Immunotherapy, and Molecular-Orthomolecular Strategies.Cancers · 2026Review
- Clear Cell Renal Cell Carcinoma with Synchronous Bladder Metastasis: Diagnostic, Surgical, and Pathological Insights from a Rare Presentation.Journal of clinical medicine · 2026Article
- A Case of Cytokine Release Syndrome Induced by Avelumab and Axitinib Combination Therapy for Metastatic Renal Cell Carcinoma.IJU case reports · 2026Article
- Updates on Clinical Trials and Molecular Characteristics of Locally Advanced and Oligometastatic Renal Cell Carcinoma.International journal of molecular sciences · 2026Review
Corrections and comments
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Authors and funding
9 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Background: Immune checkpoint inhibitor (ICI)-based combination therapies have been recommended as first-line options for metastatic renal cell carcinoma (mRCC); however, no head-to-head randomized controlled trials (RCTs) have compared all existing ICI-based therapies. Objective: We aimed to analyze the updated data to compare the efficacy of all available ICI-based options for mRCC. Design: A systematic review and Bayesian network analysis. Data sources and methods: A systematic literature search was undertaken up to September 15, 2024, and subsequent analysis was performed using a Bayesian fixed-effect model. Results: This study included 30 RCTs involving 14,959 patients. The results revealed that nivolumab plus cabozantinib (hazard ratio (HR): 0.77; 95% credible interval (CrI): 0.63-0.93), pembrolizumab plus lenvatinib (HR: 0.79; 95% CrI: 0.64-0.99), toripalimab plus axitinib (HR: 0.62; 95% CrI: 0.42-0.97), nivolumab plus ipilimumab (HR: 0.72; 95% CrI: 0.62-0.84), pembrolizumab plus axitinib (HR: 0.84; 95% CrI: 0.71-0.98), and avelumab plus axitinib (HR: 0.79; 95% CrI: 0.64-0.98) were significantly more effective than sunitinib for overall survival (OS). Most ICI-based combination treatments resulted in fewer or similar high-grade adverse events compared to sunitinib, except for pembrolizumab plus lenvatinib. For favorable-risk patients, ICI-based combination therapies were not more effective than sunitinib in OS, while six ICI-based combination therapies were associated with significantly improved OS compared to sunitinib for intermediate-risk or poor-risk patients. Conclusion: Our findings demonstrated that combination therapies including nivolumab plus cabozantinib, pembrolizumab plus lenvatinib, toripalimab plus axitinib, nivolumab plus ipilimumab, pembrolizumab plus axitinib, and avelumab plus axitinib significantly improved OS versus sunitinib. For subgroup analysis, ICI-based combination therapies exhibited significant advantages over sunitinib for intermediate-risk or poor-risk patients, while such advantages were diminished in treating favorable-risk patients.
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