SynthesisFrontiers in pharmacology2026
First-line immune checkpoint inhibitor plus anti-angiogenic therapy for advanced renal cell carcinoma: a meta-analysis of randomized controlled trials.
Synthesis in Frontiers in pharmacology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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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.
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4 authors.
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Abstract
Background: The meta-analysis assesses the efficacy and safety of first-line immune checkpoint inhibitors (ICIs) plus anti-angiogenic therapies versus sunitinib in advanced or metastatic renal cell carcinoma (RCC). The analysis places focus on differential benefits across International Metastatic RCC Database Consortium (IMDC) risk subgroups, ICI classes, and anti-angiogenic drug classes. Methods: We systematically searched the Cochrane Library, Embase and PubMed for randomized controlled trials (RCTs) comparing ICI plus anti-angiogenic therapy with sunitinib as first-line treatment for advanced RCC. Efficacy measures included progression-free survival (PFS) and overall survival (OS), objective response rate (ORR), disease control rate (DCR). Safety measures assessed grade ≥3 treatment-related adverse events (TRAEs) and TRAEs leading to discontinuation. Results: Seven RCTs involving 4,977 patients were included. Combination therapy was associated with significant improvements in PFS (0.63, [0.54-0.72]), OS (0.83, [0.77-0.89]), ORR (3.07, [2.01-4.67]), and DCR (2.04, [1.49-2.78]) (all Conclusion: TKI-based ICI combination therapy is superior to sunitinib as first-line treatment for advanced RCC, particularly in intermediate- and poor-risk patients. Anti-angiogenic agent class is the primary determinant of efficacy and tolerability, while ICI class does not influence regimen selection. These findings support a risk-adapted, class-informed approach to optimize therapeutic outcomes in clinical practice. Systematic Review registration: Identifier CRD420251273931.
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