The phase 3 CLEAR study has highlighted the significant benefits of combining lenvatinib with pembrolizumab for the treatment of advanced renal cell carcinoma (RCC). This combination therapy has shown to improve progression-free survival (PFS), overall survival (OS), and objective response rate (ORR) compared to sunitinib, a standard treatment option. The study involved patients with clear cell RCC who were randomly assigned to receive either lenvatinib plus pembrolizumab, lenvatinib plus everolimus, or sunitinib alone. The analysis focused on subgroups based on baseline features including lung, bone, and liver metastases, prior nephrectomy, and sarcomatoid histology.
Results indicated that median PFS was longer with lenvatinib plus pembrolizumab across all assessed subgroups, particularly among patients with baseline bone metastases and those with sarcomatoid features. Median OS also favored the lenvatinib plus pembrolizumab group, irrespective of metastatic lesions at baseline, prior nephrectomy, and sarcomatoid features. ORR was higher in the lenvatinib plus pembrolizumab group across all subgroups, with complete responses following a similar pattern.
The findings from the CLEAR study support the use of lenvatinib plus pembrolizumab as a first-line treatment option for patients with advanced RCC, offering improved efficacy outcomes over sunitinib. This is particularly significant for patients with specific prognostic features, suggesting that this combination therapy could be a new standard of care in the treatment of advanced RCC. The study's results are consistent with the primary analysis of the CLEAR study, reinforcing the potential of lenvatinib plus pembrolizumab in improving the prognosis for patients with advanced RCC.
