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
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Czech description
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Classification
Type
J<sub>imp</sub> - Article in a specialist periodical, which is included in the Web of Science database
CEP classification
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OECD FORD branch
30204 - Oncology
Result continuities
Project
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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
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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