Combining VEGFR tyrosine kinase inhibitors and PD-1/PD-L1 inhibitors versus VEGFR tyrosine kinase inhibitors monotherapy in renal cell carcinoma: a target trial emulation

Importance: Combinations of VEGFR tyrosine kinase inhibitors (TKIs) and immune checkpoint inhibitors (ICIs), such as antibodies to programmed cell death-1 (PD-1), or to its ligand PD-L1, are now first-line standard of care for renal cell carcinoma (RCC), but the pivotal clinical trials excluded patients with common comorbidities, leaving their real-world effectiveness uncertain. Objective: To determine whether adding PD-1/PD-L1 inhibitors to VEGFR-TKIs therapy is associated with improved overall survival in a real-world RCC cohort. Design, Setting, and Participants: This retrospective cohort study used a target trial emulation framework and real-world electronic health records data from the