Evidence map›Paper›PMID 41507833›Full record

SynthesisBMC cancer2026

Immunotherapy combinations in favourable risk score metastatic renal cell carcinoma, an individual patients data metanalysis.

Mattia Alberto Di Civita, Daniele Marinelli, Valerio Marco Michetti, Adele Artemi, Andrea Ballario, Andrea Torchia, Laura Pappalardo, Martina Pecoraro, Iolanda Speranza, Alessandro Sciarra and 3 more

Abstract readMeta-AnalysisSystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in BMC cancer, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed, 1 pooled it
–field-weighted citation impact
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

1 citing paper in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
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.

Mattia Alberto Di CivitaDepartment of Experimental Medicine, Sapienza University of Rome, Rome, 00161, Italy.
Daniele MarinelliDepartment of Experimental Medicine, Sapienza University of Rome, Rome, 00161, Italy.
Valerio Marco MichettiSapienza University of Rome, Rome, Italy.
Adele ArtemiDepartment of Radiological Sciences, Oncology and Pathology, Sapienza University of Rome, Rome, 00161, Italy.
Andrea BallarioDepartment of Radiological Sciences, Oncology and Pathology, Sapienza University of Rome, Rome, 00161, Italy.
Andrea TorchiaClinical and Molecular Medicine, Sapienza University of Rome, Rome, 00161, Italy.
Laura PappalardoDepartment of Radiological Sciences, Oncology and Pathology, Sapienza University of Rome, Rome, 00161, Italy.
Martina PecoraroDepartment of Radiological Sciences, Oncology and Pathology, Sapienza University of Rome, Rome, 00161, Italy.
Iolanda SperanzaDivision of Medical Oncology A, Policlinico Umberto I, Department of Hematology, Oncology, and Dermatology, Sapienza University of Rome, Rome, 00161, Italy.
Alessandro SciarraDepartment of Urology, Policlinico Umberto I, Sapienza University of Rome, Rome, 00161, Italy.
Valeria PanebiancoDepartment of Radiological Sciences, Oncology and Pathology, Sapienza University of Rome, Rome, 00161, Italy.
Michela Roberto *Division of Medical Oncology A, Policlinico Umberto I, Department of Hematology, Oncology, and Dermatology, Sapienza University of Rome, Rome, 00161, Italy. m.roberto@policlinicoumberto1.it.
Daniele Santini *Division of Medical Oncology B, Policlinico Umberto I, Department of Hematology, Oncology, and Dermatology, Sapienza University of Rome, Rome, 00161, Italy.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionImmuno-checkpoint inhibitors (ICIs) represent the backbone for the first line combination therapies of metastatic renal cell carcinoma (mRCC) but their advantage in the IMDC favourable risk compared to sunitinib is debated. To estimate their efficacy we present an individual patient data (IPD) meta-analysis

methodsA systematic literature search from 2015 to 2024 was conducted on the MEDLINE. Five phase III studies, 1088 patients overall, were analyzed according to PRISMA statement. (JAVELIN RENAL 101, CHECKMATE 214, KEYNOTE 426, CHECKMATE 9ER, CLEAR). An IPD meta-analysis was performed by reconstructing IPD from Kaplan-Meier curves. Primary endpoints were Progression Free Survival (PFS) and overall Survival (OS) in favorable risk patients comparing ICI-based therapies versus sunitinib as well as versus each other.

resultsFor OS, there was a statistically significant superiority of Pembrolizumab-Lenvatinib rather than Nivolumab-Cabozantinib (HR 0.56 CI 95% 0.34 -0.94), and, even non-statistically significant, vs Pembrolizumab-Axitinib (HR 0.68), vs Avelumab-Axitinib (HR 0.93), and vs Nivolumab + Ipilimumab (HR 0.95). Considering PFS, Pembrolizumab-Lenvatinib showed a significant advantage when compared to Avelumab-Axitinib (HR 0.66 CI 95% 0.46-0.96), to Nivolumab-Cabozantinib (HR 0.61 CI 95% 0.42 -0.90), to Nivolumab-Ipilimumab (HR 0.59 CI 95% 0.42-0.82) and to Pembrolizumab-Axitinib (HR 0.71 CI 95% 0.50 - 0.71).

conclusionsIn IMDC-favorable risk mRCC patients, Pembrolizumab + Lenvatinib showed the best PFS, while none of the arms showed a statistically significant OS advantage versus sunitinib. Further studies would help identify specific patients’ subgroups and establish more personalized treatment decisions.

Indexed as

Antineoplastic Combined Chemotherapy ProtocolsCarcinoma, Renal CellImmune Checkpoint InhibitorsImmunotherapyKidney NeoplasmsClinical Trials, Phase III as TopicHumansNeoplasm MetastasisProgression-Free SurvivalImmune Checkpoint Inhibitors

Identifiers

PMID41507833
PMCPMC12888583

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC-ND
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.