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Cabozantinib in combination with immune checkpoint inhibitors for renal cell carcinoma: a systematic review and meta-analysis

Affiliation
Department of Oncology ,Hangzhou Hospital of Traditional Chinese Medicine Affiliated to Zhejiang Chinese Medical University ,Hangzhou ,China
Su, Jingyang;
Affiliation
Department of Oncology ,Hangzhou Hospital of Traditional Chinese Medicine Affiliated to Zhejiang Chinese Medical University ,Hangzhou ,China
Zhang, Jialin;
Affiliation
Zhejiang Chinese Medical University ,Hangzhou ,China
Wu, Yuqian;
Affiliation
Department of Oncology ,Hangzhou Hospital of Traditional Chinese Medicine Affiliated to Zhejiang Chinese Medical University ,Hangzhou ,China
Ni, Cui;
Affiliation
Tongde Hospital of Zhejiang Province ,Hangzhou ,China
Ding, Yueyue;
Affiliation
Department of Oncology ,Hangzhou Hospital of Traditional Chinese Medicine Affiliated to Zhejiang Chinese Medical University ,Hangzhou ,China
Cai, Zelin;
Affiliation
Department of Traditional Chinese Medicine ,Ruijin Hospital ,Shanghai Jiao Tong University ,School of Medicine ,Shanghai ,China
Xu, Ming;
Affiliation
Department of Oncology ,Hangzhou Hospital of Traditional Chinese Medicine Affiliated to Zhejiang Chinese Medical University ,Hangzhou ,China
Lai, Mingyang;
Affiliation
Department of Oncology ,Hangzhou Hospital of Traditional Chinese Medicine Affiliated to Zhejiang Chinese Medical University ,Hangzhou ,China
Wang, Jue;
Affiliation
Department of Oncology ,The First Affiliated Hospital of Zhejiang Chinese Medical University ,Hangzhou ,China
Lin, Shengyou;
Affiliation
Department of Oncology ,Hangzhou Hospital of Traditional Chinese Medicine Affiliated to Zhejiang Chinese Medical University ,Hangzhou ,China
Lu, Jinhua

Context Cabozantinib combined with immune checkpoint inhibitors (ICIs) has brought a new therapeutic effect for the medical treatment of renal cell carcinoma (RCC). Objectives We performed a meta-analysis of randomized controlled trials and single-arm trials to evaluate the efficacy and safety of cabozantinib plus ICIs in RCC. Methods We extracted data from PubMed, Cochrane, Medline and Embase databases, and rated literature quality through Cochrane risk of bias tool and MINORS. RevMan5.3 software was used to analyze the results of randomized controlled trials and single-arm trials. Results A total of 7 studies were included. Treatment with cabozantinib plus ICIs improved PFS [HR 0.75, (95%CI: 0.52, 1.08), p = 0.12] and the OS [HR 0.80, (95%CI: 0.60, 1.07), p = 0.13] in randomized controlled trials. Meanwhile, the result of the ORR in randomized controlled trials was [risk ratio (RR) 1.37, (95%CI: 1.21, 1.54), p < 0.00001] and in single-arm trials was [risk difference (RD) 0.49, (95%CI: 0.26, 0.71), p < 0.0001]. Conclusion Cabozantinib plus ICIs prolonged the PFS and OS, and improved ORR in patients with RCC. Our recommendation is to use cabozantinib plus ICIs to treat advanced RCC, and to continuous monitor and manage the drug-related adverse events. Systematic Review Registration: identifier CRD42023455878.

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License Holder: Copyright © 2024 Su, Zhang, Wu, Ni, Ding, Cai, Xu, Lai, Wang, Lin and Lu.

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