Impact of Clinicopathological Features on Survival in Patients Treated with First-line Immune Checkpoint Inhibitors Plus Tyrosine Kinase Inhibitors for Renal Cell Carcinoma: A Meta-analysis of Randomized Clinical Trials

Immune checkpoint inhibitors (ICIs) have reported unprecedented results in the treatment of metastatic renal cell carcinoma, as monotherapy or in combination with other anticancer agents, including tyrosine kinase inhibitors (TKIs). Nonetheless, little information is available regarding the association between different clinicopathological features and survival in this setting. We conducted a meta-analysis aimed at assessing the impact on survival of routinely collected clinicopathological data in randomized controlled trials evaluating first-line combinations of ICIs and TKIs. Compared with the control arm, the ICI-TKI combination showed superior overall survival in all the clinicopathological subgroups (Eastern Cooperative Oncology Group performance status [ECOG-PS] 0, ECOG-PS 1, age <65 yr, age ≥65 yr, and male and female patients). In terms of pooled hazard ratio (HR), the most impressive risk of death decrease was observed in patients aged <65 yr, in whom the ICI-TKI combination decreased the risk of death by 43% (HR, 0.66; 95% confidence interval, 0.57–0.76), compared with sunitinib monotherapy.