| Objective:To systematically evaluate the efficacy and safety of targeted drugs in the treatment of metastatic non-clear cell renal carcinoma(ncc RCC)and provide guidance for clinical treatment of ncc RCC.Methods:(1)This study used the computer retrieval method to harvest the data for all observational studies and randomized controlled trials(RCTs)of patients treated with targeted drugs from the Pub Med,Embase,the Cochrane Library and the Web of Science databases,and then three independent investigators screened the literature,extracted data and evaluated the quality of the literature.We collected data on objective response rate(ORR),disease control rate(DCR),median progression free survival(PFS),and overall median survival(OS).The research was ananlyzed with Stata 17.0 software.(2)The clinical data of 41 patients with metastatic ncc RCC who were treated in the Department of Urology of the First Affiliated Hospital of the Military Medical University of the Air Force from January 2006 to December 2021 were retrospectively included.Targeted drug treatment shall be given,and the treatment shall continue until the tumor progresses or the toxic reaction that may threaten life exits,and the curative effect of patients and the occurrence of adverse drug reactions shall be evaluatedResults:(1)A total of 16 studies involving 989 patients were included.Meta-analysis results showed that the ORR of patients with metastatic ncc RCC treated with targeted drugs was 12.6%(95%CI:8.1%-17.9%),the total DCR was 65.3%(95%CI:58.3%-72.1%),and the total median PFS was 5.80(95%CI:4.69-6.91)months,The median OS was 15.93(95%CI:12.17-19.68)months.In subgroup analysis,the total ORR of patients with metastatic ncc RCC treated with sunitinib and cabozantinib was11.7%(95%CI:6.5%-18.0%)and 17.2%(95%CI:8.4%-28.2%),respectively.The total ORR of patients with papillary renal cell carcinoma was 9.1%(95%CI:2.4%-18.9%).(2)The DCR was 78.0%,10 cases of PR(24.4%),21 cases of SD(51.2%)and 9cases of PD(21.0%).ORR was 41.5%.The median PFS is 9 months(95%CI,5.8-12.17),and the median OS is 31 months(95%CI,18.26-47.73).In patients with p RCC,the median PFS was 11 months(95%CI,8.7-13.3),and the median OS was 38 months(95%CI,9.6-66.4).The median PFS of patients with ncc RCC treated with sunetinib was 11(95%CI:7.011-14.989)months,while the median PFS of sorafenib was 8(95%CI:5.370-10.630)months.There was no significant difference between the two groups(χ~2=0.159,P=0.690).The median OS of patients with ncc RCC treated with sunetinib was 37(95%CI:26.022-47.978)months,while the median OS of sorafenib was 26(95%CI:22.540-29.460)months.There was no significant difference between the two groups(χ~2=1.631,P=0.202).Conclusions:(1)Targeted drugs have a significant effect on patients with metastatic ncc RCC,but patients will have adverse reactions.Among them,metastatic papillary renal cell carcinoma has a poor effect,and cabozantinib had greater survival benefits.(2)In the real world,targeted drugs can prolong the survival time of patients.In this study,patients can basically tolerate adverse reactions. |
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