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Phase 3 CLEAR study in patients with advanced renal cell carcinoma: outcomes in subgroups for the lenvatinib-plus-pembrolizumab and sunitinib arms

The result's identifiers

  • Result code in IS VaVaI

    <a href="https://www.isvavai.cz/riv?ss=detail&h=RIV%2F00064190%3A_____%2F24%3A10001332" target="_blank" >RIV/00064190:_____/24:10001332 - isvavai.cz</a>

  • Alternative codes found

    RIV/00216208:11130/24:10482528 RIV/00064203:_____/24:10482528

  • Result on the web

    <a href="https://doi.org/10.17650/1726-9776-2024-20-1-24-35" target="_blank" >https://doi.org/10.17650/1726-9776-2024-20-1-24-35</a>

  • DOI - Digital Object Identifier

    <a href="http://dx.doi.org/10.17650/1726-9776-2024-20-1-24-35" target="_blank" >10.17650/1726-9776-2024-20-1-24-35</a>

Alternative languages

  • Result language

    ruština

  • Original language name

    [Исследование III фазы CLEAR у пациентов с распространенным почечно-клеточным раком: анализ в подгруппах больных, получавших ленватиниб с пембролизумабом и сунитиниб]

  • Original language description

    Introduction. The phase 3 CLEAR study demonstrated that lenvatinib plus pembrolizumab significantly improved efficacy versus sunitinib as first-line treatment for patients with advanced renal cell carcinoma (RCC). Prognostic features including presence and/or site of baseline metastases, prior nephrectomy, and sarcomatoid features have been associated with disease and treatment success. This subsequent analysis explores outcomes in patients with or without specific prognostic features. Methods. In CLEAR, patients with clear cell RCC were randomly assigned (1:1:1) to receive either lenvatinib (20 mg/day) plus pembrolizumab (200 mg every 3 weeks), lenvatinib (18 mg/day) plus everolimus (5 mg/day), or sunitinib alone (50 mg/day, 4 weeks on, 2 weeks off). In this report, progression-free survival, overall survival, and objective response rate were all assessed in the lenvatinib-plus-pembrolizumab and the sunitinib arms, based on baseline features: lung metastases, bone metastases, liver metastases, prior nephrectomy, and sarcomatoid histology. Results. In all the assessed subgroups, median progression-free survival was longer with lenvatinib plus-pembrolizumab than with sunitinib treatment, notably among patients with baseline bone metastases (hazard ratio (HR) 0.33; 95 % confidence interval (CI) 0.21-0.52) and patients with sarcomatoid features (HR 0.39; 95 % CI 0.18-0.84). Median overall survival favored lenvatinib plus pembrolizumab over sunitinib irrespective of metastatic lesions at baseline, prior nephrectomy, and sarcomatoid features. Of interest, among patients with baseline bone metastases the HR for survival was 0.50 (95 % CI 0.30-0.83) and among patients with sarcomatoid features the HR for survival was 0.91 (95 % CI 0.32-2.58); though for many groups, median overall survival was not reached. Objective response rate also favored lenvatinib plus pembrolizumab over sunitinib across all subgroups; similarly, complete responses also followed this pattern. Conclusion. Efficacy outcomes improved following treatment with lenvatinib-plus-pembrolizumab versus sunitinib in patients with RCC - irrespective of the presence or absence of baseline lung metastases, baseline bone metastases, baseline liver metastases, prior nephrectomy, or sarcomatoid features. These findings corroborate those of the primary CLEAR study analysis in the overall population and support lenvatinib plus pembrolizumab as a standard of care in 1L treatment for patients with advanced RCC.

  • Czech name

  • Czech description

Classification

  • Type

    J<sub>imp</sub> - Article in a specialist periodical, which is included in the Web of Science database

  • CEP classification

  • OECD FORD branch

    30204 - Oncology

Result continuities

  • Project

  • Continuities

    V - Vyzkumna aktivita podporovana z jinych verejnych zdroju

Others

  • Publication year

    2024

  • Confidentiality

    S - Úplné a pravdivé údaje o projektu nepodléhají ochraně podle zvláštních právních předpisů

Data specific for result type

  • Name of the periodical

    Onkourologiya

  • ISSN

    1726-9776

  • e-ISSN

  • Volume of the periodical

    20

  • Issue of the periodical within the volume

    1

  • Country of publishing house

    RU - RUSSIAN FEDERATION

  • Number of pages

    12

  • Pages from-to

    24-35

  • UT code for WoS article

    001249178200002

  • EID of the result in the Scopus database

    2-s2.0-85195789359