Anti-programmed cell death 1 or Anti-programmed cell death ligand 1 vs. Sunitinib for the management of advanced renal cell carcinoma ：a meta-analysis

Abstract

OBJECTIVES: To evaluate the efficacy and safety of the anti-programmed cell death 1(PD-1)/programmed cell death ligand 1(PD-L1) agents vs. sunitinib for advanced renal cell carcinoma (aRCC) treatment. METHODS: We searched for randomized controlled trials of anti-PD-1/PD-L1 and sunitinib for advanced renal cancer treatment. The databases of Pubmed, the Cochrane Library, Embase, and ClinicalTrials were included. The methodological quality of the selected trials was evaluated according to the Cochrane Handbook and the meta-analysis was performed using RevMan 5.4 software. RESULTS: Five RCTs, a total of 4771 patients, were identified and included in the present study. The meta-analysis showed that anti-PD-1/PD-L1 and sunitinib could significantly improve the overall effective rate of treatment against advanced renal cancer. The odds ratio (OR) was 1.54 (95% CI = 0.70 to 3.38, P = 0.28), suggesting that PD-1/PD-L1 inhibitors did not differ significantly in the objective response rate (ORR) compared with sunitinib in aRCC. Furthermore, when analyzing the occurrence of adverse events, the OR was 0.78 (95% CI = 0.48 to 1.62, P=0.30), suggesting that treatment with PD-1/PD-L1 inhibitors did not differ significantly in Grade III or higher adverse events (AEs) compared with sunitinib. CONCLUSION: The objective effective rate of anti-PD-1/PD-L1 in the treatment of advanced renal cancer is similar to that of sunitinib.