Background: Treatment for metastatic renal cell cancer (mRCC) has advanced dramatically with understanding of the pathogenesis of the disease. New treatment options may provide improved median progression-free survival (MPFS). We aimed to determine the relative effectiveness of new therapies in this field.
Methods: We conducted comprehensive searches of 11 electronic data bases from inception to June 8th 2013. We included randomized trials (RCTs) that evaluated everolimus or temsirolimus. Two reviewers independently extracted data, in duplicate. Our primary outcome was investigator-assessed MPFS. We performed random-effects meta-analysis.
Results: We included two everolimus and one temsirolimus trials (total n=1,424). All interventions offer advantages for PFS. We found that the median progression-free survival of the experimental group was greater than the control group, the difference was statistically significant, [SMD =0.33, 95% CI, 0.19-0.47), P<0.00001]. We pooled three trials that evaluated mTOR inhibitors versus interferon or placebo for ORR (total n=1,242) and found a pooled OR of 3.73 (95% CI, 2.80-4.97, P<0.00001). The everolimus group compared with the placebo group, the result showed that the incidence of 3-4 grade adverse events ineverolimus was significantly greater than the control group (OR =12.16, 95% CI, 7.41-7.41), P<0.00001) .One research was temsirolimus group compared with interferon group. The result showed that incidence ofadverse events results in two groups was equal [OR =0.82, 95% CI, 0.56-0.56), P<0.00001].
Conclusions: New interventions for mRCC offer a favourable MPFS and ORR but an unfavourable AES for mRCC compared to interferon and placebo.
