scholarly journals Tyrosine kinase inhibitors–induced hypothyroidism as a prognostic factor in metastatic renal cell carcinoma: a systematic review and meta-analysis

2020 ◽  
Author(s):  
Li Bo ◽  
Liang Zhou ◽  
Yin Tang ◽  
Yu Liu ◽  
Kunjie Wang ◽  
...  
Keyword(s):  
Renal Cell Carcinoma ◽  
Tyrosine Kinase ◽  
Cell Carcinoma ◽  
Tyrosine Kinase Inhibitors ◽  
Publication Bias ◽  
Renal Cell ◽  
Kinase Inhibitors ◽  
Meta Analysis ◽  
Progression Free Survival ◽  
Free Survival

Abstract Background: Hypothyroidism as a predictive factor represent highly controversial in patients with metastatic renal cell carcinoma (mRCC) with tyrosine kinase inhibitors-induced (TKI-induced) hypothyroidism. we aimed to evaluate the predictive value of TKI-induced hypothyroidism for progression-free survival (PFS) in patients with mRCC.Methods: PubMed, Web of Science and Cochrane Library databases were searched with the keywords of "renal cell carcinoma", "hypothyroidism", "tyrosine kinase inhibitor", "sunitinib", "axitinib", "sorafenib" and "pazopanib" until September 2019. The hazard ratio (HR) and 95% confidence interval (CI) of extracted from progression-free survival (PFS) were statistically analyzed by STATA15.1 software. Heterogeneity was assessed by I²value. Publication bias was appraised by the funnel chart, Egger's and Begg's tests.Results: Eighteen studies with more than 1300 patients were included in this meta-analysis. The result demonstrated that TKI-induced hypothyroidism was an effective predictor of longer PFS (HR=0.57,95%CI:0.49-0.66, P＜0.001, I²=34.4%) in patients with mRCC. No significant publication bias was detected.Conclusions: Our analysis harvested from currently available clinical evidence shows that TKI-induced hypothyroidism expressed longer PFS, compared with euthyroidism, among patients with mRCC treated with "sunitinib", "axitinib", "sorafenib" and "pazopanib".

scholarly journals Tyrosine kinase inhibitors–induced hypothyroidism as a prognostic factor in metastatic renal cell carcinoma: a systematic review and meta-analysis

2020 ◽  
Author(s):  
Li Bo ◽  
Liang Zhou ◽  
Yin Tang ◽  
Yu Liu ◽  
Hong Li ◽  
...  
Keyword(s):  
Renal Cell Carcinoma ◽  
Tyrosine Kinase ◽  
Cell Carcinoma ◽  
Tyrosine Kinase Inhibitors ◽  
Publication Bias ◽  
Renal Cell ◽  
Kinase Inhibitors ◽  
Meta Analysis ◽  
Progression Free Survival ◽  
Free Survival

Abstract Background Hypothyroidism as a predictive factor represent highly controversial in patients with metastatic renal cell carcinoma (mRCC) with tyrosine kinase inhibitors-induced (TKI-induced) hypothyroidism. we aimed to evaluate the predictive value of TKI-induced hypothyroidism for progression-free survival (PFS) in patients with mRCC. Methods PubMed, Web of Science and Cochrane Library databases were searched with the keywords of "renal cell carcinoma", "hypothyroidism", "tyrosine kinase inhibitor", "sunitinib", "axitinib", "sorafenib" and "pazopanib" until September 2019. The hazard ratio (HR) and 95% confidence interval (CI) of extracted from progression-free survival (PFS) were statistically analyzed by STATA15.1 software. Heterogeneity was assessed by I²value. Publication bias was appraised by the funnel chart, Egger's and Begg's tests. Results Eighteen studies with more than 1300 patients were included in this meta-analysis. The result demonstrated that TKI-induced hypothyroidism was an effective predictor of longer PFS (HR = 0.57,95%CI:0.49–0.66, P༜0.001, I²=34.4%) in patients with mRCC. No significant publication bias was detected. Conclusions Our analysis harvested from currently available clinical evidence shows that TKI-induced hypothyroidism expressed longer PFS, compared with euthyroidism, among patients with mRCC treated with "sunitinib", "axitinib", "sorafenib" and "pazopanib".

Prognostic and predictive role of intra-tumoral CXCR1 expression in patients receiving tyrosine kinase inhibitors for metastatic clear-cell renal cell carcinoma

2021 ◽  
pp. 205141582110122
Author(s):  
Sridhar Panaiyadiyan ◽  
Brusabhanu Nayak ◽  
Prabhjot Singh ◽  
Seema Kaushal ◽  
Subhradip Karmakar ◽  
...  
Keyword(s):  
Renal Cell Carcinoma ◽  
Tyrosine Kinase ◽  
Cell Carcinoma ◽  
Tyrosine Kinase Inhibitors ◽  
Renal Cell ◽  
Kinase Inhibitors ◽  
Clear Cell ◽  
Progression Free Survival ◽  
Cell Renal Cell Carcinoma ◽  
Free Survival

Objective: We aimed to evaluate the role of intra-tumoral CXCR1 expression in predicting prognosis and treatment response in metastatic clear-cell renal cell carcinoma patients receiving tyrosine kinase inhibitors. Materials and methods: Patients with metastatic clear-cell renal cell carcinoma presented between February 2018–December 2019 were studied for the CXCR1 expression in tumor tissues before starting tyrosine kinase inhibitors. Primary outcome measure was progression-free survival. Secondary outcome measures included overall survival and prediction of treatment response. Results: The study included 35 patients with a mean age of 53.6±9.6 years. At a mean follow-up of 12.2±4.1 months, 17 (48.6%) patients had disease progression including eight (22.9%) deaths. Patients with high CXCR1 expression, compared to those with low CXCR1 expression, had a significantly shorter 12-month progression-free survival (35.4% vs 77.9%, p=0.01) and an insignificant impact on 12-month overall survival. The CXCR1 expression scores significantly differed between patients with progressive and nonprogressive disease (20.1 vs 15.1, p=0.01) and patients with high CXCR1 expression had a reduced benefit from tyrosine kinase inhibitors. The multivariate Cox regression analysis showed CXCR1 expression as a significant predictor of progression-free survival. Conclusion: High intra-tumoral CXCR1 expression before tyrosine kinase inhibitors can be an independent prognostic factor for progression-free survival and predictor of reduced benefit in patients with metastatic clear-cell renal cell carcinoma. Level of evidence: Level 2b.

Adjuvant Tyrosine Kinase Inhibitors in Treatment of Renal Cell Carcinoma: A Meta-Analysis of Available Clinical Trials

2019 ◽  
Vol 17 (2) ◽  
pp. e339-e344 ◽  
Author(s):  
Francesco Massari ◽  
Vincenzo Di Nunno ◽  
Veronica Mollica ◽  
Jeffrey Graham ◽  
Lidia Gatto ◽  
...  
Keyword(s):  
Renal Cell Carcinoma ◽  
Clinical Trials ◽  
Tyrosine Kinase ◽  
Cell Carcinoma ◽  
Tyrosine Kinase Inhibitors ◽  
Renal Cell ◽  
Kinase Inhibitors ◽  
Meta Analysis

The merit of tyrosine kinase inhibitors in the adjuvant setting of high-risk renal cell carcinoma: a meta-analysis

2018 ◽  
Vol 14 (9) ◽  
pp. 829-835 ◽  
Author(s):  
Hampig Raphael Kourie ◽  
Ziad Bakouny ◽  
Roland Eid ◽  
Fady GH Haddad ◽  
Joseph Kattan
Keyword(s):  
Renal Cell Carcinoma ◽  
High Risk ◽  
Tyrosine Kinase ◽  
Cell Carcinoma ◽  
Tyrosine Kinase Inhibitors ◽  
Renal Cell ◽  
Kinase Inhibitors ◽  
Meta Analysis ◽  
Adjuvant Setting

Adjuvant Tyrosine Kinase Inhibitors in Renal Cell Carcinoma: A Concluded Living Systematic Review and Meta-Analysis

2021 ◽  
pp. 588-599
Author(s):  
Irbaz Bin Riaz ◽  
Rabbia Siddiqi ◽  
Mahnoor Islam ◽  
Huan He ◽  
Anum Riaz ◽  
...  
Keyword(s):  
Renal Cell Carcinoma ◽  
Clinical Trials ◽  
Tyrosine Kinase ◽  
Cell Carcinoma ◽  
Tyrosine Kinase Inhibitors ◽  
Renal Cell ◽  
Sequential Analysis ◽  
Kinase Inhibitors ◽  
Meta Analysis ◽  
Trial Sequential Analysis

PURPOSE Multiple large clinical trials have investigated adjuvant tyrosine kinase inhibitors (TKIs) to reduce the risk of cancer recurrence and progression to metastasis in high-risk renal cell carcinoma. We sought to maintain living and interactive evidence on this topic, until a high level of certainty is reached for key clinical outcomes such that further updates become unnecessary and unlikely to change clinical practice. METHODS We created a living interactive evidence synthesis platform to maintain a continuously updated meta-analysis on TKI monotherapy in adjuvant renal cell carcinoma. We implemented an automated search strategy with weekly updates to identify randomized phase 2 and 3 clinical trials. Study selection, appraisal, and data extraction were done in duplicate. Cumulative meta-analysis was performed using Analyzer Module in Living Interactive Evidence platform. For each outcome (overall survival [OS], disease-free survival [DFS], and all-cause and treatment-related adverse events), we assessed certainty of evidence using GRADE approach and conducted trial sequential analysis. RESULTS This final update includes five randomized trials including recently updated data from PROTECT trial. Meta-analysis shows that adjuvant TKI monotherapy offers no benefit in OS (hazard ratio, 1.01; 95% CI, 0.91 to 1.12, high certainty) or DFS (hazard ratio, 0.92; 95% CI, 0.86 to 1.00, high certainty) and significantly increases adverse event risk. Lack of benefit was consistent across subgroups including highest-risk patients (test for subgroup differences: P = .32). Optimal information size criteria were met, and there was high certainty of evidence for lack of DFS and OS benefit for adjuvant TKIs. CONCLUSION There is no guidance on when to stop maintaining a living review. In this example, we used trial sequential analysis and high certainty of evidence (future clinical trials unlikely to change current conclusions) as a benchmark to conclude a living review in view of convincing evidence.

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