Everolimus and temsirolimus are not the same second-line in metastatic renal cell carcinoma: a systematic review and meta-analysis

Cost Effectiveness and Resource Allocation

Review

Mahmood Salesi¹  Amir Hashemi Meshkini²  Iman Mirian³  Mehrdad Mostafavi⁴  Mojtaba Jafari⁵  Zahra Goudarzi⁵  Khosro Keshavarz⁶  Younes Ghasemi⁷ 

[1] Chemical Injuries Research Center, Systems Biology and Poisonings Institute, Baqiyatallah University of Medical Sciences, Tehran, Iran;Department of Pharmacoeconomics and Pharmaceutical Administration, Tehran University of Medical Sciences, Tehran, Iran;Department of Public Health, School of Health, Hormozgan University of Medical Sciences, Bandar Abbas, Iran;Faculty of Pharmacy, Shiraz University of Medical Sciences, Shiraz, Iran;Health Human Resources Research Center, Department of Health Economics, School of Health Management and Information Sciences, Shiraz University of Medical Sciences, Shiraz, Iran;Health Human Resources Research Center, Department of Health Economics, School of Health Management and Information Sciences, Shiraz University of Medical Sciences, Shiraz, Iran;Emergency Medicine Research Center, Shiraz University of Medical Sciences, Shiraz, Iran;Pharmaceutical Science Research Center, Shiraz University of Medical Sciences, Shiraz, Iran;

关键词: Everolimus;    mRCC;    Temsirolimus;    Clinical trial;    Efficacy;    Survival;   

DOI  :  10.1186/s12962-023-00420-4

 received in 2022-10-09, accepted in 2023-01-21,  发布年份 2023

来源: Springer

【 摘 要 】

ObjectiveRenal cell carcinoma (RCC) is the most common type of kidney cancer. VEGF inhibitors and mTORs are the most common therapeutic options among the different classes of available treatments. In this study, the effectiveness of Everolimus was compared to Temsirolimus, and Everolimus plusLenvatinib in renal cell carcinoma patients by review of the international clinical evidence.Materials and methodsA systematic review was conducted and all relevant published clinical studies on the efficacy and cost-effectiveness of Everolimus, Temsirolimus, and Lenvatinib plus Everolimus were searched comprehensively in electronic databases including Pubmed, Scopus, Medline, Cochrane Library, and ISI web of science. The Q score and I2 test checked the Heterogeneity and publication bias test, respectively. Egger’s test and Begg’s test were used to checking publication bias. The hazard ratio (HR) of included studies and subclass analysis were estimated by fixed and random effect models.ResultsOut of 1816 found studies, ultimately, were included considering inclusion and exclusion criteria. None of these studies evaluated all three treatment strategies together and each study was about one strategy. Only one study was found for Everolimus plus Lenvatinib, so it was excluded from meta-analysis. Overall, data from 526 patients on Temsirolimus and 648 patients on Everolimus were included in Meta-Analysis. Accordingly, the efficacy of Everolimus and Temsirolimus was not statistically significant in assessed outcomes (PFS, TTSF, and death). However, Everlimus is superior to Temsirolimus in OS (Q = 3.61, p-value: 0.462, I2 = 0%). No heterogeneity or bias was detected.ConclusionAccording to the results of this study, Everolimus could be related to an increase of OS versus Temsirolimus as a second line treatment of ORCC patients.

【 授权许可】

CC BY   
© The Author(s) 2023

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