Findings

What do systematic reviews say?

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Evidence found and GRADE certainty

185 questions · 194 findings · 16 reviews · Urology

No studies found 40 · 20.6%GRADE not reported 15 · 7.7%Very low 29 · 14.9%Low 71 · 36.6%Moderate 35 · 18%High 4 · 2.1%

Bevacizumab + IFN vs IFN (+ placebo) (targeted agent + classic immunotherapy versus classic immunotherapy)

Progression‐free survival · Treatment‐naïve metastatic renal cell carcinoma (clear cell type)

Bevacizumab + IFN probably leads to lower progression‐free survival (absolute effect size estimates based on… compared with IFN (+ placebo) (targeted agent + classic immunotherapy versus… (moderate certainty).

1 finding from 1 review

Pazopanib vs sunitinib (targeted agent versus targeted agent)

Progression‐free survival · Treatment‐naïve metastatic renal cell carcinoma (clear cell type)

Pazopanib showed no clear difference in progression‐free survival (absolute effect size estimates based on… compared with sunitinib (targeted agent versus targeted agent) (low certainty).

1 finding from 1 review

Bevacizumab + IFN vs IFN (+ placebo) (targeted agent + classic immunotherapy versus classic immunotherapy)

Overall survival (absolute effect size estimates based on survival rate at 24 months) · Treatment‐naïve metastatic renal cell carcinoma (clear cell type)

Bevacizumab + IFN may leads to lower overall survival (absolute effect size estimates based on survival… compared with IFN (+ placebo) (targeted agent + classic immunotherapy versus… (low certainty).

1 finding from 1 review

Bevacizumab + IFN vs IFN (+ placebo) (targeted agent + classic immunotherapy versus classic immunotherapy)

Serious adverse events (Grade 3 or 4) · Treatment‐naïve metastatic renal cell carcinoma (clear cell type)

Bevacizumab + IFN probably leads to higher serious adverse events (Grade 3 or 4) compared with IFN (+ placebo) (targeted agent + classic immunotherapy versus… (moderate certainty).

1 finding from 1 review

Temsirolimus + IFN‐α vs IFN (+ placebo) (targeted agent + classic immunotherapy versus classic immunotherapy)

Progression‐free survival · Treatment‐naïve metastatic renal cell carcinoma (any cell type)

Temsirolimus + IFN‐α may leads to lower progression‐free survival (absolute effect size estimates based on… compared with IFN‐α (targeted agent + classic immunotherapy versus classic… (low certainty).

1 finding from 1 review

Temsirolimus + IFN‐α vs IFN (+ placebo) (targeted agent + classic immunotherapy versus classic immunotherapy)

Overall survival (absolute effect size estimates based on survival rate at 12 months) · Treatment‐naïve metastatic renal cell carcinoma (any cell type)

Temsirolimus + IFN‐α showed no clear difference in overall survival (absolute effect size estimates based on survival… compared with IFN‐α (targeted agent + classic immunotherapy versus classic… (low certainty).

1 finding from 1 review

Temsirolimus + IFN‐α vs IFN (+ placebo) (targeted agent + classic immunotherapy versus classic immunotherapy)

Serious adverse events (Grade 3 or 4) · Treatment‐naïve metastatic renal cell carcinoma (any cell type)

Temsirolimus + IFN‐α may leads to higher serious adverse events (Grade 3 or 4) compared with IFN‐α (targeted agent + classic immunotherapy versus classic… (low certainty).

1 finding from 1 review

Temsirolimus + bevacizumab vs bevacizumab + IFN‐α (targeted agent + targeted agent versus targeted agent + classic immunotherapy)

Progression‐free survival · Treatment‐naïve metastatic renal cell carcinoma (any cell type)

Temsirolimus + bevacizumab showed no clear difference in progression‐free survival (absolute effect size estimates based on… compared with bevacizumab + IFN‐α (targeted agent + targeted agent versus targeted… (low certainty).

1 finding from 1 review

Temsirolimus + bevacizumab vs bevacizumab + IFN‐α (targeted agent + targeted agent versus targeted agent + classic immunotherapy)

Overall survival (absolute effect size estimates based on survival rate at 24 months) · Treatment‐naïve metastatic renal cell carcinoma (any cell type)

Temsirolimus + bevacizumab showed no clear difference in overall survival (absolute effect size estimates based on survival… compared with bevacizumab + IFN‐α (targeted agent + targeted agent versus targeted… (moderate certainty).

1 finding from 1 review

Temsirolimus + bevacizumab vs bevacizumab + IFN‐α (targeted agent + targeted agent versus targeted agent + classic immunotherapy)

Serious adverse events (Grade 3 or 4) · Treatment‐naïve metastatic renal cell carcinoma (any cell type)

Temsirolimus + bevacizumab showed no clear difference in serious adverse events (Grade 3 or 4) compared with bevacizumab + IFN‐α (targeted agent + targeted agent versus targeted… (low certainty).

1 finding from 1 review

Pazopanib vs sunitinib (targeted agent versus targeted agent)

Overall survival (absolute effect size estimates based on survival rate at 24 months) · Treatment‐naïve metastatic renal cell carcinoma (clear cell type)

Pazopanib showed no clear difference in overall survival (absolute effect size estimates based on survival… compared with sunitinib (targeted agent versus targeted agent) (low certainty).

1 finding from 1 review

Everolimus + bevacizumab vs bevacizumab + IFN‐α (targeted agent + targeted agent versus targeted agent + classic immunotherapy)

Progression‐free survival (PSF) · Treatment‐naïve metastatic renal cell carcinoma (any cell type)

It is very uncertain whether everolimus + bevacizumab changes progression‐free survival (absolute effect size estimates based on… compared with IFN α‐2a + bevacizumab (targeted agent + targeted agent versus… (very low certainty).

1 finding from 1 review

Everolimus + bevacizumab vs bevacizumab + IFN‐α (targeted agent + targeted agent versus targeted agent + classic immunotherapy)

Overall survival (absolute effect size estimates based on survival rate at 24 months) · Treatment‐naïve metastatic renal cell carcinoma (any cell type)

It is very uncertain whether everolimus + bevacizumab changes overall survival (absolute effect size estimates based on survival… compared with IFN α‐2a + bevacizumab (targeted agent + targeted agent versus… (very low certainty).

1 finding from 1 review

Everolimus + bevacizumab vs bevacizumab + IFN‐α (targeted agent + targeted agent versus targeted agent + classic immunotherapy)

Serious adverse events (Grade 3 or 4) · Treatment‐naïve metastatic renal cell carcinoma (any cell type)

Everolimus + bevacizumab showed no clear difference in serious adverse events (Grade 3 or 4) compared with IFN α‐2a + bevacizumab (targeted agent + targeted agent versus… (low certainty).

1 finding from 1 review

Sunitinib vs adjuvant immunotherapy (combined ipilimumab and nivolumab)

Progression‐free survival (PSF) · Treatment‐naïve metastatic renal cell carcinoma (clear cell type); IMDC intermediate, poor risk patients only.

Sunitinib may leads to higher progression‐free survival (absolute effect size estimates based on… compared with nivolumab + ipilimumab (targeted agent versus combinations of… (low certainty).

1 finding from 1 review

Sunitinib vs adjuvant immunotherapy (combined ipilimumab and nivolumab)

Overall survival (absolute effect size estimates based on survival rate at 12 months) · Treatment‐naïve metastatic renal cell carcinoma (clear cell type); IMDC intermediate, poor risk patients only.

Sunitinib leads to higher overall survival (absolute effect size estimates based on survival… compared with nivolumab + ipilimumab (targeted agent versus combinations of… (high certainty).

1 finding from 1 review