Advice for Oncologists and Next Steps for the CLEAR Trial in RCC

Viktor Grünwald, MD, PhD, interdisciplinary genitourinary oncology, clinic for urology and clinic for medical oncology, University Hospital Essen, Essen, Germany, discusses what the findings from the post hoc analysis of the CLEAR trial (NCT02811861) evaluating lenvatinib (Lenvima) plus pembrolizumab (Keytruda) vs sunitinib (Sutent) for the treatment of patients with renal cell carcinoma mean for community oncologists, and what the next steps for research include.

At the 2023 ESMO Annual Congress, Grünwald presented data on tumor response by baseline metastases at the final prespecified overall survival analysis time point of July 31, 2022.

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0:10 | When we speak about next steps, I think something that is really important is to understand really what is the delivery that a treatment has at a certain organ site? Because I think as a physician, I would like to know. I think we have a very good approximate when we use this approach with the target lesions, but I think ideally, we would look in depth into those CT scans and understand what is the tumor shrinkage, not only on the target lesions, but on overall, all lesions by 1 specific organ side. I think that would be also quite informative, but that's really an endeavor.

0:54 | The main question is really, let's say you have a patient with bone lesions. Will they benefit from this type of approach? Or should they be offered another combination? These are questions that you have once you sit in front of the patient, so what data do we have to support this? I think from this specific analysis, we have seen that lenvatinib/pembrolizumab was also quite efficacious in the bone lesions. It's in lymph nodes, lungs, and liver. I think that's quite informative. It is robust in its delivery, and I think these are the main takeaways for the everyday practice.