Association between age and efficacy of first-line immunotherapy-based combination therapies for mRCC: a meta-analysis

Aim: To compare the efficacy of first-line immune checkpoint inhibitor (ICI)-based combinations in metastatic renal cell carcinoma (mRCC) patients stratified by chronological age. Methods: According to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, hazard ratios for overall survival (OS) from randomized controlled trials were synthesized. Results: Five RCTs were eligible for meta-analyses. ICI-based combinations significantly improved OS compared with sunitinib alone, both in younger (<65 years) and older (=65 years) patients, whereas the OS benefit was significantly better in younger patients (p = 0.007). ICI-based combinations did not improve OS in patients aged =75 years. Treatment rankings showed age-related differential recommendations regarding improved OS. Conclusion: OS benefit from first-line ICI-based combinations was significantly greater in younger patients. Age-related differences could help enrich shared decision-making. Plain language summary: Scientists have found a special way to treat a type of cancer called metastatic renal cell carcinoma. They use a combination of medicines that help the body's immune system fight cancer. These treatments are very effective and recommended as the first choice for patients with this type cancer. However, as people get older, their immune systems may not work as well. Studies looking at how these treatments work in different age groups, and it was discovered that these treatments improved the chances of survival for all patients, no matter their age. However, they also noticed that younger patients got even more benefits from the treatments. Because of these discoveries, doctors can now make better decisions about which treatment to use for patients with this type of cancer, depending on patient age. Tweetable abstract: We assessed the differential efficacy of first-line ICI-based combinations in mRCC patients stratified by chronological age. We found that ICI-based combinations improve overall survival (OS) in younger and older patients, whereas OS benefit was significantly more pronounced in younger patients.

Automated summary

This study aimed to compare the effectiveness of first-line immune checkpoint inhibitor (ICI)-based combinations in metastatic renal cell carcinoma (mRCC) patients, stratified by age. The results showed that ICI-based combinations improved overall survival (OS) in both younger and older patients, with more pronounced benefits in younger patients.