Outcomes and side effects after first-line treatment with combination therapies for kidney cancer

This report looked at the results from 4 studies comparing sunitinib with various immunotherapy combinations: nivolumab/ipilimumab, pembrolizumab/axitinib, nivolumab/cabozantinib and pembrolizumab/lenvatinib. Overall survival time, time to when the cancer started growing again and the treatment stopped working (progression-free survival), response to treatment in terms of the cancer getting smaller, and side effects to treatment were all analysed.

Overall, 3,320 patients were included in the analysis. Nivolumab/cabozantinib ranked first in terms of overall survival time, followed by pembrolizumab/lenvatinib, pembrolizumab/axitinib and nivolumab/ipilimumab. Regarding progression-free survival and response to treatment, pembrolizumab/lenvatinib ranked first followed by nivolumab/cabozantinib, pembrolizumab/axitinib and nivolumab/ipilimumab. Finally, nivolumab/ipilimumab ranked first with respect to the lowest number of serious or life-threatening side effects, followed by pembrolizumab/axitinib, nivolumab/cabozantinib and pembrolizumab/lenvatinib.

Nivolumab/cabozantinib appears to be the best combination for overall survival time, pembrolizumab/lenvatinib for progression-free survival and response to treatment, and nivolumab/ipilimumab the safest treatment in terms of side effects. However, differences in the populations of patients in the 4 studies could undermine these findings.

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