What's The Next Era Of Immune Checkpoint Inhibitors Of Renal Cell Carcinoma In Clinical Practice: An Evidence From Extended Bibliometric Analysis

Abstract

Objectives: To use bibliometric analysis to articles regarding RCC treating by ICIs, extended analysis effect, and safety of enrolled paper to interpret the current situation and future trend of clinical trials. Methods: We searched in the WoSCC Database on May 30, 2021. Articles were ranked in descending order based on their total citations. Also, we investigated the uncovered trials registered in ClinicalTrials.gov to analyze the trend of the future of ICI treatment. Results: The top 30 most cited articles were identified and analyzed. The most productive year was 2020, with 12 articles published. The USA and Memorial Sloan Kettering Cancer Center were the most effective country and institutions. The 15 journals contributed to these articles, and the top five keywords were survival, therapy, nivolumab, everolimus, and immunotherapy. The 13 original articles registered on ClinicalTrials.gov: monotherapy was 38.5% and combined therapy was 61.5%. The ORR of monotherapy and combined therapy was 24.05% vs 49.03% (P< 0.001). The mPFS of monotherapy was shorter than combined therapy (4.01 mo vs 14.51 mo, P< 0.001). The incidence of grade 3/4 adverse events in single-agent was significantly lower than combined therapy (19.76% vs 59.38%, P< 0.001). 91 grey data were extracted from ClinicalTrials.gov, which included single-agent (11%) and combination therapy (89%). Conclusions: Although the side effect is unfavorable, the combined therapy will replace the single-agent ICI treatment in the future clinical trial design. The effect of treatment based on PD-1, PD-L1, and CTLA-4 has almost reached the bottleneck, the scientist should focus on new targets of checkpoints in clinical research.