Meta-analysis Of The Efficacy Of Sunitinib Schedule 2/1 And Schedule 4/2 In The Treatment Of Metastatic Renal Cell Cancer

Objective:As the standard treatment for metastatic renal cancer(mRCC),sunitinib schedule 4/2 will have more adverse reactions in the treatment process.In order to further illustrate the feasibility of schedule 2/1,this study systematically evaluated the efficacy and adverse reactions of sunitinib schedule 2/1 and schedule 4/2 in the treatment of mRCC through meta analysis.Methods:The databases retrieved included the published case control studies at home and abroad,including the Embase,Pubmed,BioMed Central,Cinahl,Cochrane Library,etc.The retrieval time is from the database establishment to October 25,2018.the Review Manager 5.3 software was used for data analysis.Results:There were 6 foreign literatures,and 1 Chinese literatures met the inclus ion criteria,a total of 417 patients.By Meta analysis showed:(1)In terms of efficacy,compared with schedule 4/2,schedule 2/1 has obvious advantages in controlling SD of mRCC patients,and the difference is statistically significant(OR=0.55,95%CI:0.34~0.89,P=0.01).(2)In terms of adverse events,compared with schedule 4/2,schedule 2/1 in controlling neutropenia(OR=2.70,95%CI:1.69~4.32,P<0.001),leukopenia(OR=1.97,95%CI:1.22~3.17,P=0.005),anemia(OR=1.67,95%CI:1.12~2.50,P = 0.01),fatigue(OR = 3.85,95% CI: 2.54 ~ 5.83,P < 0.001),hypertension(OR = 1.82,95% CI: 1.25 ~ 2.65,P = 0.002),hypothyroidism(OR = 1.90,95% CI: 1.01 ~ 3.59,P = 0.05),Hand-Foot syndrome(OR = 2.85,95% CI: 1.61 ~ 5.04,P < 0.001),the stomatitis or mucosal inflammation(OR = 2.50,95% CI: 1.36 ~ 4.59.P = 0.003)has statistically significant differences.The incidence of grade 3~4 thrombocytopenia(OR=1.82,95%CI:1.03~3.23,P=0.04),diarrhea(OR=2.67,95%CI:1.01~7.10,P=0.05),stomatitis or mucositis(OR=4.12,95%CI:1.25~13.52,P=0.02)in schedule 2/1 was lower than that in schedule 4/2,with statistically significant differences.Conclusion:(1)The efficacy of sunitinib schedule 2/1 is comparable to that of schedule 4/2 in the treatment of metastatic renal cancer,and schedule 2/1has significant advantages in the control of mRCC patients’ SD(P=0.01).(2)Schedule 2/1 improved the patient’s tolerance to sunitinib compared with the schedule 4/2.(3)Sunitinib schedule 2/1 is a safe and effective treatment regimen.However,the above conclusions need to be further verified by more large-sample randomized controlled studies.