Evaluation of immunotherapy and targeted therapy treatment on renal cell carcinoma: A Bayesian network analysis

Clinical trials have previously assessed various therapies for renal cell carcinoma (RCC); however, there is currently a lack of direct comparisons between these therapies. The present study identified published studies on RCC through Web of Science, PubMed, EMBASE, Cochrane Library of Controlled Trials and Clinical trials.gov that were written in the English language and published by February 2019. The data were selected and extracted independently by two reviewers. Standard pair-wise meta-analyses were performed using Stata. Network meta-analyses were subsequently performed using WinBUGS (version 1.4.3). The primary outcome of the present study was progression-free survival (PFS). Secondary outcomes included overall survival (OS), objective response rate (ORR) and adverse events of various targeted therapies. The results were presented as cumulative odds ratio, hazard ratio, corresponding 95% confidence interval and the surface under the cumulative ranking curve, which was used to rank the probabilities and outcome of each treatment in RCC. A total of 31 eligible publications for 18 randomized controlled trials consisting of 11,498 participants were included in the present study. The network meta-analyses revealed that a combination of lenvantinib and everolimus ranked first out of 16 treatments in terms of PFS, OS and ORR (probability of 54.0, 53.4 and 61.0%, respectively).