title: A comparison of drug resistances of targeted drugs for advanced renal cell cancer approved by the Food and Drug Administration: A meta-analysis of randomized clinical trials.
abstract: OBJECTIVE
  The purpose of this study was to conduct network meta-analysis to assess drug resistances of the Food and Drug Administration-approved drugs for advanced renal cell carcinoma.
  
  
  METHODS
  Database searches were conducted to identify randomized controlled trials reporting results for eligible treatments. After searching for PubMed, MEDLINE, EMBASE, and ISI Web of Science, 22 studies (n = 7854 patients) were included for the comparison of drug resistance in the present meta-analysis.
  
  
  RESULTS
  For overall present, the mean 6-month progression-free survival rates were 65.4%, 49.3%, 60.6%, 70.3%, 62.6%, 41.6%, 38.2%, 66.1%, 43.1%, and 17.9% for sunitinib, sorafenib, pazopanib, axitinib, bevacizumab plus interferon (IFN)-a, everolimus, temsirolimus, temsirolimus plus bevacizumab, IFN-a, and placebo, respectively. For indirect comparison, two combined therapies (bevacizumab plus IFN-a and temsirolimus plus bevacizumab) and sunitinib were of less ability of drug resistance. The risk ratio of sunitinib therapy was 3.64 (95% confidence interval [CI] [3.12, 4.25]), the risk ratio of temsirolimus plus bevacizumab therapy was 3.68 (95% CI [3.14, 4.33]), and the risk ratio of bevacizumab plus IFN-a therapy was 3.49 (95% CI [2.99, 4.06]).
  
  
  CONCLUSIONS
  Our results support that combination of targeted therapies might be a novel strategy against advanced renal cell carcinomas.
authors.affiliation: Department of Hematology, 2nd Affiliated Hospital, Beijing University of Traditional Chinese Medicine, Beijing, 100078, China.
authors.forename: Ming
authors.initials: M
authors.lastname: Guo
authors.affiliation: Department of Nephrology, 2nd Affiliated Hospital, Beijing University of Traditional Chinese Medicine, Beijing, 100078, China.
authors.forename: Yunsong
authors.initials: Y
authors.lastname: Cao
authors.affiliation: Department of Urology and Andragogy, 2nd Affiliated Hospital, Beijing University of Traditional Chinese Medicine, Beijing, 100078, China.
authors.forename: Jingzhe
authors.initials: J
authors.lastname: Yang
authors.affiliation: Department of Nephrology, 2nd Affiliated Hospital, Beijing University of Traditional Chinese Medicine, Beijing, 100078, China.
authors.forename: Jingfeng
authors.initials: J
authors.lastname: Zhang
mesh_terms: D000970:Antineoplastic Agents / Q000627:therapeutic use*; D002292:Carcinoma, Renal Cell / Q000188:drug therapy* / Q000401:mortality / Q000473:pathology*; D018572:Disease-Free Survival; D017277:Drug Approval; D019008:Drug Resistance, Neoplasm; D006801:Humans; D007680:Kidney Neoplasms / Q000188:drug therapy* / Q000401:mortality / Q000473:pathology*; D058990:Molecular Targeted Therapy; D009367:Neoplasm Staging; D016017:Odds Ratio; D017594:Publication Bias; D016032:Randomized Controlled Trials as Topic; D016896:Treatment Outcome; D014481:United States; D014486:United States Food and Drug Administration
chemical_list: D000970:Antineoplastic Agents