
A post hoc analysis of the CLEAR trial, presented at the Hematology/Oncology Pharmacy Association Annual Conference 2024, found clinically relevant efficacy of lenvatinib plus pembrolizumab compared with sunitinib as a first-line treatment for patients with advanced renal cell carcinoma.
The CLEAR trial compared three regimens: lenvatinib plus pembrolizumab, lenvatinib plus everolimus, and sunitinib. For this post hoc study, lenvatinib plus pembrolizumab was compared with sunitinib in regard to tumor response, progression-free survival (PFS), and duration of response (DOR). In total, 355 patients were in the lenvatinib and pembrolizumab group and 357 patients were in the sunitinib group. The researchers compared outcomes in subgroups with baseline lung, lymph node, bone, liver, and brain metastases.
In all subgroups, PFS favored the lenvatinib plus pembrolizumab group. The hazard ratio (HR) for disease progression with this regimen was 0.47 (95% CI, 0.38–0.57). The objective response rate was also greater in the lenvatinib treatment group (71.3%) compared with the sunitinib group (36.7%). The HR for response with lenvatinib and pembrolizumab versus sunitinib was 4.31 (95% CI, 3.14–5.92). The median DOR for the lenvatinib regimen was 26.7 months compared with 14.7 months with sunitinib.
“Greater depth and breadth of tumor shrinkage at nadir was observed in target lesions in specific organ sites (lung, lymph node, liver, and bone) for patients in the lenvatinib plus pembrolizumab arm versus the sunitinib arm,” the authors noted.
“Results of this post hoc analysis further support the early, deep, and durable tumor response benefit with lenvatinib plus pembrolizumab versus sunitinib observed in the CLEAR trial,” they concluded.
Reference
Grünwald V, McKay RR, Buchler, et al. Tumor response by baseline metastases in patients with renal cell carcinoma treated with lenvatinib plus pembrolizumab vs sunitinib: post hoc analysis of the CLEAR trial. Poster. Presented at the Hematology/Oncology Pharmacy Association Annual Conference 2024; April 3-6, 2024; Tampa, Florida.