The power of meta-analysis in therapeutic decision making for advanced kidney cancer

Despite being a relatively uncommon cancer, kidney cancer has made tremendous advances over the past two decades. In fact, it has served as the blueprint for proof of principle of various targeted and immune therapies. A plethora of clinical trials have been reported and completed in this disease within the last decade. The results have led to a paradigm shift in the management approach towards renal cell carcinoma (RCC). Multiple complicated factors need to be considered during the decisions regarding systemic therapy, along with the interplay of sequencing with local therapies. The paper by Wallis et al. (1) focuses on the current treatment dilemma of front line therapy options in patients with newly diagnosed metastatic or advanced kidney cancer. A meta-analysis of the data from the randomized trials comparing front line systemic therapies, conducted in this disease state, form the subject matter of the paper. The study is an attempt to simplify therapeutic choices with evaluating a large body of evidence and condensing it into crystallized evidence-based recommendations. The analysis spans a patient experience of 13,128 cases of untreated advanced RCC enrolled across 37 clinical trials