| OBJECTIVE:Evaluate the effectiveness and safety of targeted drugs in renal cell carcinoma, through the method recommended by the Cochrane collaboration.METHODS: According to the standard of inclusion and exclusion criterion, related researches had been collected from Cochrane library, Pub Med and EMBASE via computer search. Randomized controlled trials, retrospective studys and cohort study of renal cell carcinoma targeted drugs were collected and analysed. Meta-analyses were performed with Revman 5.3 software.RESULTS: The eligible number of effective study and safety study are 23 and 12 respectively. The results suggest that Interferon-a in combination with bevacizumab significantly prolonged PFS[HR=0.51,95%CI(0.26,0.99),P=0.05] and OS [HR=0.51,95%CI(0.26,0.99),P=0.05] as first-line treatment for m RCC compared with Interferon-a alone. A significantly higher incidence of grade ≥3 adverse events such as diarrhea and fatigue was observed in the Axitinib group than in the Sorafenib group[OR=1.58,95%(1.00,2.49),P=0.05] [OR=2.98,95%CI(1.63,5.45),P=0.0004], and higher risks of hypertension[OR=3.76,95%CI( 0.37, 38.58), P=0.26]. However, Sorafenib group showed a significantly higher incidence of hand-foot syndrome[OR=0.32,95%CI(0.21,0.49),P<0.00001]. Targeted drugs showed a higher risks of adverse reactions than immunotherapy(interferon) and hormone therapys. A higher incidence ofgrade ≥3 adverse events was observed in the Tivozanib group and Sorafenib group with the rates of 61.39% and 61.87%.CONCLUSIONS: According to this research, Bevacizumab in combination with Interferon-a show a good efficacy, which are effective treatment of renal cell carcinoma; In the treatment of renal cell carcinoma,Axitinib has a good effectiveness,but safety is relatively low; m TOR inhibitors have lower incidence of ADR than TKI inhibitors, such as hypertension and hand-foot syndrome, that shows relatively higher safety. |
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