Targeted oncology
Adjuvant Systemic Therapies After Nephrectomy for Renal Cell Carcinoma: A Bayesian Network Meta-Analysis and Multi-Criteria Benefit-Risk Assessment
By Yajima S, Okumura G, Yoshida S and 6 others.
Abstract
Background
Adjuvant pembrolizumab has improved disease-free survival after nephrectomy for high-risk renal cell carcinoma, and pembrolizumab plus belzutifan has further expanded the treatment landscape.
Objective
We compared efficacy and treatment burden across adjuvant systemic therapies and examined the benefit-risk trade-off of the combination.
Methods
Randomized trials of systemic therapy after nephrectomy were synthesized using a Bayesian network meta-analysis. Disease-free survival hazard ratios were converted to illustrative 2-year estimates using a common pembrolizumab baseline. Observed differences in 2-year disease-free survival, grade 3 or higher adverse events, and treatment discontinuation came from LITESPARK-022. Using these data, a multi-criteria decision analysis examined how outcome weighting affected the balance between the two regimens.