Related Experiment Video
Updated: Aug 28, 2025
A Syngeneic Mouse Model of Metastatic Renal Cell Carcinoma for Quantitative and Longitudinal Assessment of Preclinical Therapies
Published on: April 12, 2017
Systemic therapies for metastatic renal cell carcinoma in the second-line setting: A systematic review and network
Yang Liao1, Haifeng Hou, Zhenhua Han
1Department of Urology, Jiangjin District Central Hospital, Chongqing, China.
Objectives:
To perform a systematic review and network meta-analysis to compare the survival benefit and safety profile of current available second-line treatment options of metastatic renal cell carcinomav.
Methods:
PubMed, EMBASE, Web of Science, and Cochrane Library were systematically researched for eligible articles which were published before July 20, 2021. Studies comparing overall/progression free survival (OS/PFS), objective response rate (ORR), and/or adverse events (AEs) in patients with metastatic renal cell carcinomav were included.
Results:
Nine trials (with 4911 patients) were finally included for final network meta-analysis. Cabozantinib, lenvatinib, and lenvatinib plus everolimus were associated with significantly better PFS, OS, and ORR compared with everolimus, and lenvatinib plus everolimus emerged as the best option. As for grade 3 to 4 AEs, nivolumab showed significantly lower risk of AEs compared with everolimus. Other included treatments were associated with significantly increased risk of AEs. When comprehensively assessed the efficacy and safety of included treatments based on the ranking analysis of PFS, ORR, and grade 3 to 4 AEs, lenvatinib plus everolimus, cabozantinib, and nivolumab showed superior efficacy over other treatments, with relatively lower risk of grade 3 to 4 AEs.
Conclusions:
Among all included therapies, Lenvatinib plus everolimus was identified as the most effective treatment approach, with the best PFS, OS, and ORR. nivolumab was associated with decreased incidence of grade 3 to 4 AEs among included treatment therapies. When comprehensively evaluated the efficacy and safety of included treatment options, lenvatinib plus everolimus, cabozantinb, and nivolumab were associated with better survival benefits and lower risk of AEs. Future studies should focus on the direct comparison of different second-line treatment in real-world populations.
Insights
Lenvatinib plus everolimus offers the best survival benefit and response rates for metastatic renal cell carcinoma. Nivolumab shows a lower risk of severe adverse events, with lenvatinib plus everolimus, cabozantinib, and nivolumab being top choices.
Area of Science:
- Oncology
- Pharmacology
- Clinical Trials
Background:
- Metastatic renal cell carcinoma (mRCC) requires effective second-line treatments.
- Current treatment options vary in efficacy and safety profiles.
Purpose of the Study:
- To systematically review and network meta-analyze survival benefits and safety of second-line treatments for mRCC.
- To identify optimal treatment strategies based on efficacy and safety data.
Main Methods:
- Systematic literature search of PubMed, EMBASE, Web of Science, and Cochrane Library up to July 20, 2021.
- Network meta-analysis of nine trials (4911 patients) comparing overall survival (OS), progression-free survival (PFS), objective response rate (ORR), and adverse events (AEs).
Main Results:
- Lenvatinib plus everolimus demonstrated superior PFS, OS, and ORR compared to everolimus.
- Nivolumab had a significantly lower risk of grade 3-4 AEs than everolimus.
- Lenvatinib plus everolimus, cabozantinib, and nivolumab showed superior efficacy with relatively lower AE risk.
Conclusions:
- Lenvatinib plus everolimus is the most effective second-line treatment for mRCC, offering the best survival and response.
- Nivolumab is associated with a decreased incidence of severe adverse events.
- Lenvatinib plus everolimus, cabozantinib, and nivolumab represent superior treatment options considering both efficacy and safety.
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