Observational studyInternational journal of cancer2026
Head-to-head comparison of TKI and CPI first-line treatment strategies in advanced renal cell carcinoma-Real-world data from the German research platform CARAT.
Observational study in International journal of cancer, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT03374267 (Clinical Research Platform On Urologic Cancer Treatment And Outcome), which is not on this map. Cited by 5 papers, 1 of them a synthesis that pooled 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.
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.
Clinical Research Platform On Urologic Cancer Treatment And Outcome (Registry Platform Urologic Cancer; CARAT)
Who cites it
5 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Real-World Comparative Effectiveness and Safety of Immune Checkpoint Inhibitors in Advanced Renal Cell Carcinoma: A Systematic Review.Targeted oncology · 2026Pooled it
- Prospective, longitudinal oncology registries enabling advanced real-world evidence: the iOMEDICO experience.ESMO real world data and digital oncology · 2026Article
- Head-to-head comparison of TKI and CPI first-line treatment strategies in advanced renal cell carcinoma-Real-world data from the German research platform CARAT.International journal of cancer · 2026Observational
- Real-world comparison of the efficacy of first-line therapies and the influence of risk factors in advanced renal cell carcinoma.Discover oncology · 2025Article
- Tivozanib Monotherapy in the Frontline Setting for Patients with Metastatic Renal Cell Carcinoma and Favorable Prognosis.Current oncology reports · 2024Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
16 authors.
Funding
Abstract
The combination of two immune checkpoint inhibitors (CPI) or a CPI with a tyrosine kinase inhibitor (TKI) has expanded the therapeutic options for advanced/metastatic renal cell carcinoma (aRCC) beyond TKI monotherapy. In the absence of head-to-head randomized trials comparing these strategies, we estimate their real-world effectiveness by emulating a hypothetical randomized trial. A total of 936 patients with aRCC from the prospective, observational, multicenter clinical registry CARAT (NCT03374267) starting first-line treatment after January 15, 2019, were included. Inverse probability of treatment weighting (IPTW) was used to compare first-line CPI + TKI (n = 447), CPI + CPI (n = 257), and TKI monotherapy (n = 166). Real-world progression-free survival (rwPFS), overall survival (OS), and time-to-deterioration (TTD) of health-related quality of life (HRQoL) were analyzed, also stratified by patients' prognostic risk according to the International Metastatic Renal Cell Carcinoma Database Consortium (IMDC) model. IPTW-adjusted median rwPFS and OS independent of IMDC risk were 12.3 [10.4-15.6] and 29.0 months [25.6-36.3] for TKI + CPI, 8.3 [6.5-10.9] and 21.9 months [16.3-34.5] for CPI + CPI, and 8.5 [6.4-10.0] and 31.7 months [21.0-40.0] for TKI monotherapy. Compared to CPI + TKI, survival tended to be worse for CPI + CPI (rwPFS: hazard ratio (HR) 1.25 [1.00-1.58]; OS: HR 1.25 [0.95, 1.63]). This finding was more pronounced for rwPFS in patients at intermediate risk. Median TTD of HRQoL did not substantially differ between the strategies. Despite the lack of statistically significant HR differences in rwPFS and OS, there was a trend toward superior survival with first-line CPI + TKI compared to CPI + CPI. TKI monotherapy may remain a viable first-line treatment option in selected patient populations. Further analyses, preferentially randomized clinical trials, are warranted.
Indexed as
Identifiers
What OpenQuestion holds
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.