Summary

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• This summary is based on the review of 32 systematic review(s)/meta-analysis(es). ^[1-32]
• Axitinib Monotherapy in Advanced Renal Cell Carcinoma (RCC) After Prior Therapy: Median progression-free survival (PFS) ranged between 5.5 and 8.7 months, with median overall survival (OS) ranging from 11.0 to 69.5 months.
• Combination Therapy Effectiveness: Pembrolizumab plus Axitinib achieved the highest PFS and OS rates in several studies, while Nivolumab plus Cabozantinib and Pembrolizumab plus Lenvatinib showed significant PFS improvements. Nivolumab plus Ipilimumab was effective for intermediate and poor-risk groups, and Avelumab plus Axitinib was beneficial for PFS and objective response rate (ORR) in favorable-risk patients.
• Comparative Efficacy Among Combinations: Pembrolizumab plus Axitinib demonstrated superior OS and PFS over Sunitinib, while outperforming Axitinib plus Avelumab in OS and PFS outcomes. Axitinib-based combinations generally improved outcomes compared to Sunitinib monotherapy.
• Network Meta-Analysis Findings: Pembrolizumab plus Axitinib ranked highest for OS and PFS across studies, with Pembrolizumab plus Lenvatinib also ranking highly for OS and PFS. Nivolumab plus Ipilimumab showed favorable OS specifically in intermediate and poor-risk groups.
• Common adverse effects of Axitinib included hypertension, hand-foot syndrome, and fatigue, with a notably higher incidence of both all-grade and grade ≥3 hypertension compared to placebo, while thromboembolism (DVT/PE) and hypothyroidism risks were not increased.
• Combination therapy of Pembrolizumab plus Axitinib showed higher incidences of grade ≥3 adverse events than Sunitinib, whereas Nivolumab plus Ipilimumab exhibited lower rates of grade ≥3 adverse events.
• Pembrolizumab plus Lenvatinib was associated with a higher incidence of serious adverse events, and although Nivolumab plus Ipilimumab had lower grade ≥3 adverse events, it led to higher rates of treatment discontinuation due to adverse effects.
• Elderly patients (>65 years) demonstrated improved OS with Pembrolizumab plus Axitinib; favorable-risk patients benefited from Avelumab plus Axitinib for PFS; intermediate and poor-risk groups saw higher efficacy with Pembrolizumab plus Axitinib and Nivolumab plus Ipilimumab, while efficacy and safety were consistent across genders, and patients with cardiovascular comorbidities required monitoring due to high-grade hypertension risks with Axitinib.