All patients
Age < 65y (younger) Age > 65y Gender, female Gender, male PD-L1 < 1% PD-L1 > 1% PDL1 (CPS < 1) PDL1 (CPS >1) Risk favorable (IMDC) Risk favorable (MSKCC) Risk intermediate (IMDC) Risk intermediate (MSKCC) Risk poor (IMDC) Risk poor (MSKCC)
Top evidence (RCT only, high risk of bias excluded)
Best available evidence (possibly low or very low)
All RCTs
All studies (RCT+OBS)
renal cell cancer (RCC), pembrolizumab based treatment vs. all, meta-analysis of study results Outcome TE 95% CI n k I2 ROB Pub. bias deaths (OS)detailed results KEYNOTE-426, 2019 0.53 [0.38; 0.74]
KEYNOTE-581/CLEAR (PDL1), 2021 0.66 [0.49; 0.88]
0.60 [0.48 ; 0.75 ] KEYNOTE-426, 2019, KEYNOTE-581/CLEAR (PDL1), 2021 2 0% 1,573 moderate not evaluable deaths (OS) (extension)detailed results KEYNOTE-426, 2019 0.68 [0.55; 0.85]
0.68 [0.55 ; 0.85 ] KEYNOTE-426, 2019 1 0% 861 NA not evaluable PFS (extension)detailed results KEYNOTE-426, 2019 0.71 [0.60; 0.84]
0.71 [0.60 ; 0.84 ] KEYNOTE-426, 2019 1 0% 861 NA not evaluable progression or deaths (PFS)detailed results KEYNOTE-426, 2019 0.69 [0.57; 0.84]
KEYNOTE-581/CLEAR (PDL1), 2021 0.39 [0.32; 0.48]
0.52 [0.30 ; 0.91 ] KEYNOTE-426, 2019, KEYNOTE-581/CLEAR (PDL1), 2021 2 93% 1,573 moderate not evaluable objective responses (ORR)detailed results KEYNOTE-426, 2019 2.07 [1.58; 2.73]
KEYNOTE-581/CLEAR (PDL1), 2021 1.97 [1.69; 2.29]
1.99 [1.75 ; 2.28 ] KEYNOTE-426, 2019, KEYNOTE-581/CLEAR (PDL1), 2021 2 0% 1,573 moderate not evaluable objective responses (ORR) (extension)detailed results KEYNOTE-426, 2019 2.28 [1.74; 3.00]
2.28 [1.74 ; 3.00 ] KEYNOTE-426, 2019 1 0% 861 NA not evaluable AE (any grade)detailed results Out of scale KEYNOTE-581/CLEAR (PDL1), 2021 NaN [NaN; NaN]
NaN [NaN ; NaN ] KEYNOTE-581/CLEAR (PDL1), 2021 1 0% 592 NA not evaluable AE (grade 3-4)detailed results KEYNOTE-581/CLEAR (PDL1), 2021 0.11 [0.05; 0.24]
0.11 [0.05 ; 0.24 ] KEYNOTE-581/CLEAR (PDL1), 2021 1 0% 592 NA not evaluable AE leading to death (grade 5)detailed results KEYNOTE-426, 2019 0.72 [0.33; 1.58]
KEYNOTE-581/CLEAR (PDL1), 2021 0.93 [0.42; 2.05]
0.82 [0.47 ; 1.43 ] KEYNOTE-426, 2019, KEYNOTE-581/CLEAR (PDL1), 2021 2 0% 1,446 moderate not evaluable AE leading to treatment discontinuation (any grade)detailed results KEYNOTE-581/CLEAR (PDL1), 2021 2.31 [1.58; 3.38]
2.31 [1.58 ; 3.38 ] KEYNOTE-581/CLEAR (PDL1), 2021 1 0% 592 NA not evaluable TRAE (any grade)detailed results KEYNOTE-426, 2019 0.62 [0.28; 1.39]
0.62 [0.28 ; 1.39 ] KEYNOTE-426, 2019 1 0% 854 NA not evaluable TRAE (grade 3-4)detailed results KEYNOTE-426, 2019 1.26 [0.96; 1.65]
1.26 [0.96 ; 1.65 ] KEYNOTE-426, 2019 1 0% 854 NA not evaluable TRAE leading to death (grade 5)detailed results KEYNOTE-426, 2019 0.56 [0.16; 1.93]
0.56 [0.16 ; 1.93 ] KEYNOTE-426, 2019 1 0% 854 NA not evaluable TRAE leading to discontinuation (any grade)detailed results KEYNOTE-426, 2019 3.10 [2.12; 4.54]
3.10 [2.12 ; 4.54 ] KEYNOTE-426, 2019 1 0% 854 NA not evaluable Adrenal insufficiency TRAE (grade 3-4)detailed results KEYNOTE-426, 2019 5.98 [0.30; 119.72]
5.98 [0.30 ; 119.72 ] KEYNOTE-426, 2019 1 0% 854 NA not evaluable Anaemia TRAE (grade 3-4)detailed results KEYNOTE-426, 2019 0.07 [0.01; 0.57]
0.07 [0.01 ; 0.57 ] KEYNOTE-426, 2019 1 0% 854 NA not evaluable Arthralgia TRAE (grade 3-4)detailed results KEYNOTE-426, 2019 1.49 [0.25; 8.96]
1.49 [0.25 ; 8.96 ] KEYNOTE-426, 2019 1 0% 854 NA not evaluable Asthenia TRAE (grade 3-4)detailed results KEYNOTE-426, 2019 0.49 [0.18; 1.31]
0.49 [0.18 ; 1.31 ] KEYNOTE-426, 2019 1 0% 854 NA not evaluable Colitis TRAE (grade 3-4)detailed results KEYNOTE-426, 2019 16.13 [0.92; 281.80]
16.13 [0.92 ; 281.80 ] KEYNOTE-426, 2019 1 0% 854 NA not evaluable Decreased appetite TRAE (grade 3-4)detailed results KEYNOTE-426, 2019 4.53 [0.97; 21.10]
4.53 [0.97 ; 21.10 ] KEYNOTE-426, 2019 1 0% 854 NA not evaluable Diabetes TRAE (grade 3-4)detailed results KEYNOTE-426, 2019 1.98 [0.07; 59.29]
1.98 [0.07 ; 59.29 ] KEYNOTE-426, 2019 1 0% 854 NA not evaluable Diarrhoea TRAE (grade 3-4)detailed results KEYNOTE-426, 2019 1.66 [0.92; 3.00]
1.66 [0.92 ; 3.00 ] KEYNOTE-426, 2019 1 0% 854 NA not evaluable Dysgeusia TRAE (grade 3-4)detailed results KEYNOTE-426, 2019 1.98 [0.07; 59.29]
1.98 [0.07 ; 59.29 ] KEYNOTE-426, 2019 1 0% 854 NA not evaluable Dyspepsia TRAE (grade 3-4)detailed results KEYNOTE-426, 2019 0.49 [0.02; 14.79]
0.49 [0.02 ; 14.79 ] KEYNOTE-426, 2019 1 0% 854 NA not evaluable Dysphonia TRAE (grade 3-4)detailed results KEYNOTE-426, 2019 1.98 [0.07; 59.29]
1.98 [0.07 ; 59.29 ] KEYNOTE-426, 2019 1 0% 854 NA not evaluable Fatigue TRAE (grade 3-4)detailed results KEYNOTE-426, 2019 0.46 [0.21; 0.99]
0.46 [0.21 ; 0.99 ] KEYNOTE-426, 2019 1 0% 854 NA not evaluable Hepatitis TRAE (grade 3-4)detailed results Out of scale KEYNOTE-426, 2019 20.26 [1.18; 348.03]
20.26 [1.18 ; 348.03 ] KEYNOTE-426, 2019 1 0% 854 NA not evaluable Hypertension TRAE (grade 3-4)detailed results KEYNOTE-426, 2019 1.20 [0.85; 1.68]
1.20 [0.85 ; 1.68 ] KEYNOTE-426, 2019 1 0% 854 NA not evaluable Hyperthyroidism TRAE (grade 3-4)detailed results KEYNOTE-426, 2019 10.01 [0.55; 183.83]
10.01 [0.55 ; 183.83 ] KEYNOTE-426, 2019 1 0% 854 NA not evaluable Hypophysitis TRAE (grade 3-4)detailed results KEYNOTE-426, 2019 7.99 [0.42; 151.61]
7.99 [0.42 ; 151.61 ] KEYNOTE-426, 2019 1 0% 854 NA not evaluable Hypothyroidism TRAE (grade 3-4)detailed results KEYNOTE-426, 2019 0.99 [0.06; 15.89]
0.99 [0.06 ; 15.89 ] KEYNOTE-426, 2019 1 0% 854 NA not evaluable Increase AST TRAE (grade 3-4)detailed results KEYNOTE-426, 2019 4.33 [1.88; 10.00]
4.33 [1.88 ; 10.00 ] KEYNOTE-426, 2019 1 0% 854 NA not evaluable Increased ALT TRAE (grade 3-4)detailed results KEYNOTE-426, 2019 5.19 [2.67; 10.10]
5.19 [2.67 ; 10.10 ] KEYNOTE-426, 2019 1 0% 854 NA not evaluable Infusion-related reactions TRAE (grade 3-4)detailed results KEYNOTE-426, 2019 0.99 [0.06; 15.89]
0.99 [0.06 ; 15.89 ] KEYNOTE-426, 2019 1 0% 854 NA not evaluable Mucosal inflammation TRAE (grade 3-4)detailed results KEYNOTE-426, 2019 0.56 [0.16; 1.93]
0.56 [0.16 ; 1.93 ] KEYNOTE-426, 2019 1 0% 854 NA not evaluable Myocarditis TRAE (grade 3-4)detailed results KEYNOTE-426, 2019 1.98 [0.07; 59.29]
1.98 [0.07 ; 59.29 ] KEYNOTE-426, 2019 1 0% 854 NA not evaluable Myositis TRAE (grade 3-4)detailed results KEYNOTE-426, 2019 1.98 [0.07; 59.29]
1.98 [0.07 ; 59.29 ] KEYNOTE-426, 2019 1 0% 854 NA not evaluable Nausea TRAE (grade 3-4)detailed results KEYNOTE-426, 2019 0.49 [0.09; 2.71]
0.49 [0.09 ; 2.71 ] KEYNOTE-426, 2019 1 0% 854 NA not evaluable Nephritis TRAE (grade 3-4)detailed results KEYNOTE-426, 2019 1.98 [0.07; 59.29]
1.98 [0.07 ; 59.29 ] KEYNOTE-426, 2019 1 0% 854 NA not evaluable Neutropenia TRAE (grade 3-4)detailed results KEYNOTE-426, 2019 0.03 [0.00; 0.24]
0.03 [0.00 ; 0.24 ] KEYNOTE-426, 2019 1 0% 854 NA not evaluable Palmar-plantar erythrodysaesthesia syndrome TRAE (grade 3-4)detailed results KEYNOTE-426, 2019 1.48 [0.76; 2.89]
1.48 [0.76 ; 2.89 ] KEYNOTE-426, 2019 1 0% 854 NA not evaluable Pancreatitis TRAE (grade 3-4)detailed results KEYNOTE-426, 2019 0.99 [0.14; 7.07]
0.99 [0.14 ; 7.07 ] KEYNOTE-426, 2019 1 0% 854 NA not evaluable Pneumonitis TRAE (grade 3-4)detailed results KEYNOTE-426, 2019 1.98 [0.07; 59.29]
1.98 [0.07 ; 59.29 ] KEYNOTE-426, 2019 1 0% 854 NA not evaluable Proteinuria TRAE (grade 3-4)detailed results KEYNOTE-426, 2019 1.84 [0.67; 5.02]
1.84 [0.67 ; 5.02 ] KEYNOTE-426, 2019 1 0% 854 NA not evaluable Pruritus TRAE (grade 3-4)detailed results KEYNOTE-426, 2019 1.98 [0.07; 59.29]
1.98 [0.07 ; 59.29 ] KEYNOTE-426, 2019 1 0% 854 NA not evaluable Rash TRAE (grade 3-4)detailed results KEYNOTE-426, 2019 0.99 [0.06; 15.89]
0.99 [0.06 ; 15.89 ] KEYNOTE-426, 2019 1 0% 854 NA not evaluable Severe skin reaction TRAE (grade 3-4)detailed results KEYNOTE-426, 2019 1.66 [0.39; 6.99]
1.66 [0.39 ; 6.99 ] KEYNOTE-426, 2019 1 0% 854 NA not evaluable Stomatitis TRAE (grade 3-4)detailed results KEYNOTE-426, 2019 0.33 [0.09; 1.21]
0.33 [0.09 ; 1.21 ] KEYNOTE-426, 2019 1 0% 854 NA not evaluable Thrombocytopenia TRAE (grade 3-4)detailed results KEYNOTE-426, 2019 0.02 [0.00; 0.35]
0.02 [0.00 ; 0.35 ] KEYNOTE-426, 2019 1 0% 854 NA not evaluable Thyroiditis TRAE (grade 3-4)detailed results KEYNOTE-426, 2019 1.98 [0.07; 59.29]
1.98 [0.07 ; 59.29 ] KEYNOTE-426, 2019 1 0% 854 NA not evaluable Uveitis TRAE (grade 3-4)detailed results KEYNOTE-426, 2019 0.99 [0.02; 50.04]
0.99 [0.02 ; 50.04 ] KEYNOTE-426, 2019 1 0% 854 NA not evaluable Vomiting TRAE (grade 3-4)detailed results KEYNOTE-426, 2019 0.33 [0.03; 3.17]
0.33 [0.03 ; 3.17 ] KEYNOTE-426, 2019 1 0% 854 NA not evaluable Abdominal pain AE (grade 3-4)detailed results KEYNOTE-426, 2019 5.00 [0.58; 42.98]
5.00 [0.58 ; 42.98 ] KEYNOTE-426, 2019 1 0% 854 NA not evaluable Anaemia AE (grade 3-4)detailed results KEYNOTE-426, 2019 0.14 [0.04; 0.46]
0.14 [0.04 ; 0.46 ] KEYNOTE-426, 2019 1 0% 854 NA not evaluable Arthralgia AE (grade 3-4)detailed results KEYNOTE-426, 2019 1.32 [0.29; 5.95]
KEYNOTE-581/CLEAR (PDL1), 2021 4.88 [0.57; 42.03]
2.03 [0.59 ; 6.96 ] KEYNOTE-426, 2019, KEYNOTE-581/CLEAR (PDL1), 2021 2 0% 1,546 moderate not evaluable Asthenia AE (grade 3-4)detailed results KEYNOTE-426, 2019 0.83 [0.37; 1.88]
0.83 [0.37 ; 1.88 ] KEYNOTE-426, 2019 1 0% 854 NA not evaluable Back pain AE (grade 3-4)detailed results KEYNOTE-426, 2019 0.56 [0.16; 1.93]
0.56 [0.16 ; 1.93 ] KEYNOTE-426, 2019 1 0% 854 NA not evaluable Blood creatinine increased AE (grade 3-4)detailed results KEYNOTE-426, 2019 0.66 [0.11; 3.96]
0.66 [0.11 ; 3.96 ] KEYNOTE-426, 2019 1 0% 854 NA not evaluable Constipation AE (grade 3-4)detailed results KEYNOTE-426, 2019 0.49 [0.02; 14.79]
KEYNOTE-581/CLEAR (PDL1), 2021 5.84 [0.29; 116.96]
1.94 [0.18 ; 21.52 ] KEYNOTE-426, 2019, KEYNOTE-581/CLEAR (PDL1), 2021 2 12% 1,546 moderate not evaluable Cough AE (grade 3-4)detailed results KEYNOTE-426, 2019 0.49 [0.04; 5.47]
0.49 [0.04 ; 5.47 ] KEYNOTE-426, 2019 1 0% 854 NA not evaluable Decreased appetite AE (grade 3-4)detailed results KEYNOTE-426, 2019 4.05 [1.13; 14.45]
KEYNOTE-581/CLEAR (PDL1), 2021 2.78 [0.99; 7.79]
3.22 [1.45 ; 7.19 ] KEYNOTE-426, 2019, KEYNOTE-581/CLEAR (PDL1), 2021 2 0% 1,546 moderate not evaluable Diarrhoea AE (grade 3-4)detailed results KEYNOTE-426, 2019 2.03 [1.16; 3.53]
KEYNOTE-581/CLEAR (PDL1), 2021 1.91 [1.06; 3.46]
1.97 [1.31 ; 2.96 ] KEYNOTE-426, 2019, KEYNOTE-581/CLEAR (PDL1), 2021 2 0% 1,546 moderate not evaluable Dysgeusia AE (grade 3-4)detailed results KEYNOTE-426, 2019 1.98 [0.07; 59.29]
KEYNOTE-581/CLEAR (PDL1), 2021 0.97 [0.06; 15.50]
1.29 [0.15 ; 11.06 ] KEYNOTE-426, 2019, KEYNOTE-581/CLEAR (PDL1), 2021 2 0% 1,546 moderate not evaluable Dyspepsia AE (grade 3-4)detailed results KEYNOTE-426, 2019 0.49 [0.02; 14.79]
0.49 [0.02 ; 14.79 ] KEYNOTE-426, 2019 1 0% 854 NA not evaluable Dysphonia AE (grade 3-4)detailed results KEYNOTE-426, 2019 1.98 [0.07; 59.29]
KEYNOTE-581/CLEAR (PDL1), 2021 0.97 [0.02; 48.82]
1.46 [0.11 ; 19.00 ] KEYNOTE-426, 2019, KEYNOTE-581/CLEAR (PDL1), 2021 2 0% 1,546 moderate not evaluable Dyspnoea AE (grade 3-4)detailed results KEYNOTE-426, 2019 1.39 [0.44; 4.43]
1.39 [0.44 ; 4.43 ] KEYNOTE-426, 2019 1 0% 854 NA not evaluable Fatigue AE (grade 3-4)detailed results KEYNOTE-426, 2019 0.41 [0.20; 0.81]
KEYNOTE-581/CLEAR (PDL1), 2021 0.96 [0.46; 2.00]
0.62 [0.27 ; 1.44 ] KEYNOTE-426, 2019, KEYNOTE-581/CLEAR (PDL1), 2021 2 64% 1,546 moderate not evaluable Headache AE (grade 3-4)detailed results KEYNOTE-426, 2019 1.99 [0.36; 10.93]
1.99 [0.36 ; 10.93 ] KEYNOTE-426, 2019 1 0% 854 NA not evaluable Hypertension AE (grade 3-4)detailed results KEYNOTE-426, 2019 1.19 [0.85; 1.66]
KEYNOTE-581/CLEAR (PDL1), 2021 1.64 [1.15; 2.35]
1.39 [1.01 ; 1.90 ] KEYNOTE-426, 2019, KEYNOTE-581/CLEAR (PDL1), 2021 2 40% 1,546 moderate not evaluable Hyperthyroidism AE (grade 3-4)detailed results KEYNOTE-426, 2019 10.01 [0.55; 183.83]
10.01 [0.55 ; 183.83 ] KEYNOTE-426, 2019 1 0% 854 NA not evaluable Hypothyroidism AE (grade 3-4)detailed results KEYNOTE-426, 2019 0.99 [0.06; 15.89]
KEYNOTE-581/CLEAR (PDL1), 2021 9.78 [0.53; 179.78]
2.98 [0.32 ; 28.06 ] KEYNOTE-426, 2019, KEYNOTE-581/CLEAR (PDL1), 2021 2 20% 1,546 moderate not evaluable Increase AST AE (grade 3-4)detailed results KEYNOTE-426, 2019 3.12 [1.51; 6.47]
3.12 [1.51 ; 6.47 ] KEYNOTE-426, 2019 1 0% 854 NA not evaluable Increased ALT AE (grade 3-4)detailed results KEYNOTE-426, 2019 4.86 [2.62; 9.01]
4.86 [2.62 ; 9.01 ] KEYNOTE-426, 2019 1 0% 854 NA not evaluable Mucosal inflammation AE (grade 3-4)detailed results KEYNOTE-426, 2019 0.49 [0.15; 1.64]
0.49 [0.15 ; 1.64 ] KEYNOTE-426, 2019 1 0% 854 NA not evaluable Nausea AE (grade 3-4)detailed results KEYNOTE-426, 2019 0.99 [0.25; 3.99]
KEYNOTE-581/CLEAR (PDL1), 2021 4.43 [0.95; 20.68]
2.02 [0.47 ; 8.75 ] KEYNOTE-426, 2019, KEYNOTE-581/CLEAR (PDL1), 2021 2 50% 1,546 moderate not evaluable Neutropenia AE (grade 3-4)detailed results KEYNOTE-426, 2019 0.03 [0.00; 0.24]
0.03 [0.00 ; 0.24 ] KEYNOTE-426, 2019 1 0% 854 NA not evaluable Palmar–plantar erythrodysesthesia syndrome AE (grade 3-4)detailed results KEYNOTE-426, 2019 1.38 [0.72; 2.67]
KEYNOTE-581/CLEAR (PDL1), 2021 1.04 [0.48; 2.25]
1.23 [0.74 ; 2.02 ] KEYNOTE-426, 2019, KEYNOTE-581/CLEAR (PDL1), 2021 2 0% 1,546 moderate not evaluable Proteinuria AE (grade 3-4)detailed results KEYNOTE-426, 2019 2.01 [0.75; 5.40]
KEYNOTE-581/CLEAR (PDL1), 2021 2.74 [1.31; 5.76]
2.45 [1.35 ; 4.44 ] KEYNOTE-426, 2019, KEYNOTE-581/CLEAR (PDL1), 2021 2 0% 1,546 moderate not evaluable Pruritus AE (grade 3-4)detailed results KEYNOTE-426, 2019 1.98 [0.07; 59.29]
1.98 [0.07 ; 59.29 ] KEYNOTE-426, 2019 1 0% 854 NA not evaluable Pyrexia AE (grade 3-4)detailed results KEYNOTE-426, 2019 0.99 [0.02; 50.04]
0.99 [0.02 ; 50.04 ] KEYNOTE-426, 2019 1 0% 854 NA not evaluable Rash AE (grade 3-4)detailed results KEYNOTE-426, 2019 0.49 [0.04; 5.47]
KEYNOTE-581/CLEAR (PDL1), 2021 6.48 [1.45; 28.94]
2.14 [0.18 ; 26.02 ] KEYNOTE-426, 2019, KEYNOTE-581/CLEAR (PDL1), 2021 2 68% 1,546 moderate not evaluable Stomatitis AE (grade 3-4)detailed results KEYNOTE-426, 2019 0.33 [0.09; 1.21]
KEYNOTE-581/CLEAR (PDL1), 2021 0.82 [0.27; 2.48]
0.56 [0.23 ; 1.37 ] KEYNOTE-426, 2019, KEYNOTE-581/CLEAR (PDL1), 2021 2 12% 1,546 moderate not evaluable Thrombocytopenia AE (grade 3-4)detailed results KEYNOTE-426, 2019 0.02 [0.00; 0.31]
0.02 [0.00 ; 0.31 ] KEYNOTE-426, 2019 1 0% 854 NA not evaluable Vomiting AE (grade 3-4)detailed results KEYNOTE-426, 2019 0.25 [0.03; 2.21]
KEYNOTE-581/CLEAR (PDL1), 2021 2.36 [0.82; 6.79]
0.94 [0.11 ; 8.34 ] KEYNOTE-426, 2019, KEYNOTE-581/CLEAR (PDL1), 2021 2 70% 1,546 moderate not evaluable Weight decreased AE (grade 3-4)detailed results KEYNOTE-426, 2019 13.25 [1.73; 101.75]
KEYNOTE-581/CLEAR (PDL1), 2021 29.30 [3.96; 216.58]
19.85 [4.76 ; 82.76 ] KEYNOTE-426, 2019, KEYNOTE-581/CLEAR (PDL1), 2021 2 0% 1,546 moderate not evaluable 0.0 20.0 1.0 relative treatment effect www.metaEvidence.org 2024-05-20 18:11 +02:00
TE: relative treatment effect (measured by a risk ratio, an odds ratio or an hazard ratio depending on what is reported in the papers);
k: number of studies; n: total number of patients;
ROB: risk of bias (ROB 2.0); Pub. bias: publication bias; OBS: observational studies; RCT: randomized clinical trials
pathologies: 10,93,79,178,152,80
- treatments: 847,982,359,575,577,576,869,1081,981,875,505,952,1021,1079,767,1071,1074,873,561
