Geographical Differences in Kidney Cancer Outcomes of Patients Treated with Immunotherapy: A Systematic Review

IF 1.1 Q4 ONCOLOGY Kidney Cancer Pub Date : 2022-06-23 DOI:10.3233/kca-210124
V. Gonçalves, F. Monteiro, Antonia Angeli Gazola, Felipe Pizzolo, Júlia Elisa Hübner, R. Pellegrini, Alessandra Borba, A. Fay
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Abstract

BACKGROUND: Immune checkpoint inhibitors (ICI) have shown clinical benefit among patients with advanced kidney cancer. Their cost burden hardens its access, especially in low- and middle-income countries. To set solutions, the impact of geographical and socioeconomic differences in the clinical outcomes and survival of renal cell carcinoma (RCC) patients needs to be explored. OBJECTIVE: This review aimed to understand if geographical differences affected the clinical outcomes of RCC patients receiving immunotherapy. METHODS: This study reviewed 45 studies that examined the OS and PFS of RCC patients undergoing ICI (2010–2020) selected from a 3028-study database search conducted on PubMed and grey literature. The selected studies were divided into groups: Asia, multicentric studies, Europe and Anglo-America. The lethality and income of the geographical locations were measured and discussed. RESULTS: Weighted average (WAVG) of mPFS and mOS were 8,47 months, and 40,6 months in Asia. The WAVG of mOS were 12.2 months, and 20.22 months in the Anglo-American population (15 studies; 943 patients). In multicentric studies (4 studies; 1834 patients) the WAVG mPFS was 10,06. European group (13 studies; 3143 patients) had 6.1 and 20.24 months mPFS and mOS, respectively. The exploratory analysis on income and RCC lethality has shown an absolute decline of 8.7% (CI 10.1 to 7.3% - p <  0.05) in RCC lethality, when income is raised by 100% . CONCLUSION: Clinical benefit from ICI varies across the globe. A wide access to ICI, and evaluation of biological aspects of the disease will allow a better understanding of the impact of geographic regions in the clinical outcome of patients receiving ICI and the etiology of potential differences.
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免疫治疗肾癌患者预后的地理差异:一项系统综述
背景:免疫检查点抑制剂(ICI)在晚期癌症患者中显示出临床疗效。它们的成本负担使其准入更加困难,尤其是在中低收入国家。为了制定解决方案,需要探讨地理和社会经济差异对肾细胞癌(RCC)患者临床结果和生存率的影响。目的:本综述旨在了解地理差异是否影响接受免疫治疗的RCC患者的临床结果。方法:本研究回顾了45项研究,这些研究检查了接受ICI的RCC患者的OS和PFS(2010-2020),这些研究选自PubMed和灰色文献上进行的3028项研究数据库搜索。选定的研究被分为以下几组:亚洲、多中心研究、欧洲和英美。测量并讨论了地理位置的杀伤力和收入。结果:亚洲mPFS和mOS的加权平均值分别为8,47个月和40,6个月。在英美人群中,mOS的WAVG分别为12.2个月和20.22个月(15项研究;943名患者)。在多中心研究(4项研究;1834名患者)中,WAVG mPFS为10,06。欧洲组(13项研究;3143名患者)的mPFS和mPOS分别为6.1个月和20.24个月。对收入和碾压混凝土致死率的探索性分析显示,绝对下降了8.7%(CI 10.1-7.3%-p <  0.05)在碾压混凝土致死率中,当收入提高100%时。结论:ICI的临床益处在全球范围内各不相同。广泛接触ICI,并对疾病的生物学方面进行评估,将有助于更好地了解地理区域对接受ICI的患者临床结果的影响以及潜在差异的病因。
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来源期刊
Kidney Cancer
Kidney Cancer Multiple-
CiteScore
0.90
自引率
8.30%
发文量
23
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