Second-line cabozantinib versus nivolumab in advanced renal cell carcinoma: Systematic review and indirect treatment comparison

Crit Rev Oncol Hematol. 2019 Jul:139:143-148. doi: 10.1016/j.critrevonc.2018.10.004. Epub 2018 Oct 24.

Abstract

Background: Nivolumab and cabozantinib, two new treatment options for previously-treated advanced/metastatic renal cell carcinoma (aRCC), have recently been approved.

Methods: Two independent reviewers performed study selection, data extraction, and risk of bias assessment. Indirect treatment comparisons were carried out by directly assessing HR differences and statistical modeling of Kaplan-Meier curves from these two trials.

Results: Publications identified showed that no head-to-head comparisons had been carried out. Two indirect treatment comparisons used agreed that there was no significant difference in OS between cabozantinib and nivolumab and that cabozantinib significantly improved PFS compared to nivolumab.

Conclusions: The field of aRCC treatments is evolving rapidly, creating opportunities for individualized treatments and challenges for clinicians to keep up with the evidence. In lieu of availability of direct comparisons of all options, advanced modeling results presented herein can help to inform and improve personalized treatments.

Keywords: Advanced modeling; Individualized cancer therapy; Treatment algorithm.

Publication types

  • Comparative Study
  • Systematic Review

MeSH terms

  • Anilides / therapeutic use*
  • Antineoplastic Agents, Immunological / therapeutic use*
  • Carcinoma, Renal Cell / drug therapy*
  • Carcinoma, Renal Cell / pathology
  • Humans
  • Kidney Neoplasms / drug therapy*
  • Kidney Neoplasms / pathology
  • Nivolumab / therapeutic use*
  • Pyridines / therapeutic use*
  • Treatment Outcome

Substances

  • Anilides
  • Antineoplastic Agents, Immunological
  • Pyridines
  • cabozantinib
  • Nivolumab