First-Line Therapy For Advanced Non-Clear Cell Renal Cell Carcinoma: A Systematic Review and Meta-Analysis.

Understanding the benefits of combining immunotherapy and targeted therapy for these subtypes is crucial for improving patient outcomes.

理解将免疫治疗和靶向治疗相结合对这些亚型的好处对于改善患者预后至关重要。

Background

To evaluate the efficacy of various first-line immunotherapy combinations and targeted therapy in treating metastatic nccRCC.

评估各种一线免疫治疗联合方案和靶向治疗在治疗转移性非透明细胞肾细胞癌中的疗效。

data_sources

A systematic literature search was conducted across PubMed, Embase, and Cochrane Library databases from inception until December 31, 2024, using relevant keywords and medical subject headings terms.

从数据库建立开始至2024年12月31日，使用相关关键词和医学主题词在PubMed、Embase和Cochrane图书馆数据库中进行了系统的文献检索。

study_selection

Studies were included if they involved patients with nccRCC, reported on immune checkpoint inhibitor(ICI)-based therapies, and provided data on objective response rate(ORR), progression-free survival(PFS), overall survival(OS), and disease control rate (DCR).

如果研究涉及非透明细胞肾细胞癌(nccRCC)患者，报告了基于免疫检查点抑制剂(ICIs)的治疗，并提供了关于客观缓解率(ORR)、无进展生存期(PFS)、总生存期(OS)和疾病控制率(DCR)的数据，则被纳入研究。

data_extraction_and_synthesis

Two independent reviewers extracted data, with discrepancies resolved by a third expert.

两位独立的审查员提取数据，分歧由第三位专家解决。

Observational study quality was assessed using the Newcastle-Ottawa Scale.

使用纽卡斯尔-渥太华量表评估观察性研究的质量。

A random-effects meta-analysiswas performed, and heterogeneity was evaluated using the I2 statistic.

进行了随机效应的荟萃分析，并使用I2统计量评估异质性。

main_outcome_and_measures

The primary outcomes of interest were ORR, PFS, OS, and DCR.

主要关注的结局指标包括客观缓解率（ORR）、无进展生存期（PFS）、总生存（OS）和疾病控制率（DCR）。

Results

The analysis included 23 studies encompassing various subtypes of nccRCC.

分析纳入了23项研究，涵盖了各种非典型肾细胞癌（nccRCC）的亚型。

Pooled results indicated an ORR of 26.6% and a DCR of 57.8% for nccRCC treatments.

汇总结果显示，对于非典型肾细胞癌（nccRCC）治疗，客观缓解率（ORR）为26.6%，疾病控制率（DCR）为57.8%。

Median PFS was 6.59 months, and the median OS was 21.11 months.

无进展生存期（PFS）的中位数为6.59个月，总生存期（OS）的中位数为21.11个月。

ICIs demonstrated significant efficacy in nccRCC, exhibiting marked clinical activity across different subtypes.

ICIs在非典型肾细胞癌（nccRCC）中显示出显著的疗效，对不同亚型表现出明显的临床活性。

Although monotherapy with ICIs showed effectiveness, combination therapies yielded superior clinical outcomes.

尽管ICIs单药治疗显示出有效性，但联合治疗产生了更优越的临床结果。

conclusions_and_relevance

This systematic reviewand meta-analysisfound that ICIs, particularly when combined with targeted therapies, showed promising efficacy in treating metastatic nccRCC.

这项系统评价和荟萃分析发现，免疫检查点抑制剂（ICIs），特别是与靶向治疗联合使用时，在治疗转移性非透明细胞肾细胞癌（nccRCC）方面显示出有希望的疗效。

These findings support their integration into treatment guidelines and emphasize the importance of personalized treatment strategies.

这些发现支持将它们纳入治疗指南，并强调了个性化治疗策略的重要性。

Future research should focus on long-term outcomes, safety profiles, and the identification of biomarkers to optimize patient selection and improve outcomes.

未来的研究应关注长期结果、安全性特征以及生物标志物的识别，以优化患者选择并改善结果。