Lenvatinib outdoes other TKIs in improving survival in metastatic RCC

Patients with metastatic renal cell carcinoma (RCC) may gain significantly better survival outcomes with lenvatinib therapy than with other tyrosine kinase inhibitors (TKIs), suggests a study.

Notably, the use of lenvatinib is associated with some adverse events (AEs), but its safety profile is similar to that of other TKIs.

A team of investigators conducted this meta-analysis by initially searching for relevant studies in the databases of PubMed, Web of Science, Cochrance Library, and Scopus from inception to February 2024. Those reporting on the efficacy and safety of lenvatinib alone or in combination with other TKIs versus other TKIs for metastatic RCC were included.

Progression-free (PFS) and overall survival (OS) were the primary outcomes, while objective response rate (ORR), AEs, and health-related quality of life (QOL) were secondary.

Overall, 17 studies met the eligibility criteria. Treatment with lenvatinib, especially when combined with TKIs, resulted in significant improvements in PFS (hazard ratio, 0.46, 95 percent confidence interval [CI], 0.38‒0.54; p<0.001) and OS (HR, 0.80, 95 percent CI, 0.70‒0.91; P<0.001) versus other TKIs.

Results were mixed in terms of QOL, with EQ-5D showing significant improvements (HR, 1.21, 95 percent CI, 0.90‒1.53; p<0.001), while EORTC QLQ-C30 did not reach statistical significance. For ORR, lenvatinib was associated with a higher probability of achieving a complete or partial response (OR, 2.04, 95 percent CI, 1.15‒2.93; p=0.001).

On the other hand, AEs grade >3 did not significantly differ between lenvatinib and other TKIs (OR, ‒0.08, 95 percent CI, ‒0.21 to 0.06; p=0.26).