Summary of findings 4. Sorafenib compared to pazopanib (targeted agent versus targeted agent).
| Patient or population: Treatment‐naïve metastatic renal cell carcinoma (any cell type) Setting: Multinational muticentre/likely outpatient Intervention: Sorafenib Comparison: Pazopanib | |||||
| Outcomes | № of participants (studies) | Certainty of the evidence (GRADE) | Relative effect (95% CI) | Anticipated absolute effects* (95% CI) | |
| Risk with Pazopanib | Risk difference with Sorafenib | ||||
|
Progression‐free survival (absolute effect size estimates based on survival rate at 12 months) follow‐up: not reported |
377 (1 RCT) | ⊕⊕⊕⊝ MODERATE 1 | HR 1.92 (1.74 to 2.11) | Study population | |
| 380 per 1000 | 224 fewer per 1000 (250 fewer to 194 fewer) | ||||
|
Overall survival (absolute effect size estimates based on survival rate at 24 months) follow‐up: not reported |
377 (1 RCT) | ⊕⊕⊝⊝ LOW 2 3 | HR 1.22 (0.91 to 1.64) | Study population | |
| 520 per 1000 | 70 fewer per 1000 (178 fewer to 32 more) | ||||
| Serious adverse events (Grade 3 or 4) assessed with: CTCAE v4.03 | 366 (1 RCT) | ⊕⊝⊝⊝ VERY LOW 1 4 | RR 0.92 (0.78 to 1.09) | Study population | |
| 639 per 1000 | 51 fewer per 1000 (141 fewer to 58 more) | ||||
|
Health‐related quality of life
(mean change value)
assessed with: FACIT‐F (higher scores indicating less fatigue)
Scale from: 0 to 52 follow‐up: not reported |
267 (1 RCT) | ⊕⊕⊝⊝ LOW 5 6 | ‐ | The mean health‐related quality of life was ‐9.9 | MD 3.1 higher (1.82 lower to 8.02 higher) |
| *The risk in the intervention group (and its 95% CI) is based on the assumed risk in the comparison group and the relative effect of the intervention (and its 95% CI). CI: Confidence interval; CTCAE: Common Terminology Criteria for Adverse Events;FACIT‐F: Functional Assessment of Chronic Illness Therapy–Fatigue scale; HR: Hazard ratio; RCT: Randomized controlled trial; RR: Risk ratio | |||||
| GRADE Working Group grades of evidence High certainty: We are very confident that the true effect lies close to that of the estimate of the effect Moderate certainty: We are moderately confident in the effect estimate: The true effect is likely to be close to the estimate of the effect, but there is a possibility that it is substantially different Low certainty: Our confidence in the effect estimate is limited: The true effect may be substantially different from the estimate of the effect Very low certainty: We have very little confidence in the effect estimate: The true effect is likely to be substantially different from the estimate of effect | |||||
1 Downgraded by 1 level for study limitations; unclear risk of selection, detection, and reporting bias and high risk of performance bias
2 Downgraded by 1 level for study limitations; unclear risk of selection, and reporting bias
3 Downgraded by 1 level for imprecision; confidence interval crossed the line of no difference and the assumed threshold of a clinically important difference (included harm and no harm)
4 Downgraded by 2 levels for imprecision; confidence interval crossed the line of no difference and the assumed threshold of a clinically important difference: wide confidence interval (included both benefit and harm)
5 Downgraded by 1 level for study limitations; unclear risk of selection, detection, and reporting bias and high risk of performance and attrition bias
6 Downgraded by 1 level for imprecision; confidence interval crossed the line of no difference and the assumed threshold of a clinically important difference (3 points, included benefit and no benefit)