Resumen

Este estudio comparará la eficacia y seguridad de belzutifan + lenvatinib frente a cabozantinib en participantes con carcinoma de células renales (CCR) avanzado con componente de células claras tras terapia previa. La hipótesis principal es que belzutifan + lenvatinib es superior a cabozantinib en términos de supervivencia libre de progresión o supervivencia global.

Elegibilidad

Edad mínima: 18 YearsSexo: ALL

Criterios de inclusión

Unresectable, locally advanced or metastatic clear cell renal cell carcinoma (RCC).
Disease progression on or after an anti-programmed cell death-1/ligand 1 (PD-1/L1) therapy as either first or second-line treatment for locally advanced/metastatic RCC or as adjuvant treatment or neoadjuvant/adjuvant with progression on or within 6 months of last dose.
Measurable disease per RECIST 1.1 criteria as assessed by local study investigator.
Karnofsky performance status (KPS) score of at least 70% assessed within 10 days before randomization.
Received no more than 2 prior systemic regimens including: one anti-PD-1/L1 containing adjuvant or neoadjuvant/adjuvant regimens with progression on or within 6 months from the last dose of that regimen OR one or 2 regimens for locoregional/advanced disease
Received only 1 prior antiPD-1/L1 therapy for adjuvant, neoadjuvant/adjuvant or locally advanced/metastatic RCC.
A male participant is eligible to participate if he is abstinent from heterosexual intercourse or agrees to use contraception during the intervention period and for at least 7 days after the last dose of belzutifan or lenvatinib in the belzutifan+lenvatinib arm, whichever occurs last, and 23 days after the last dose of cabozantinib.
A female participant is eligible to participate if they are not pregnant, not breastfeeding, and at least 1 of the following conditions applies: Not a woman of childbearing potential (WOCBP) or a WOCBP who agrees to follow the contraceptive guidance during the intervention period and for at least 30 days after the last dose of study intervention in the belzutifan+ lenvatinib arm, or 120 days after the last dose of study intervention in the cabozantinib arm.
Adequately controlled blood pressure.
Adequate organ function.

Criterios de exclusión

A pulse oximeter reading \<92% at rest, requires intermittent supplemental oxygen, or requires chronic supplemental oxygen.
Known additional malignancy that is progressing or has required active treatment within the past 3 years except for basal cell carcinoma of the skin, squamous cell carcinoma of the skin, or carcinoma in situ (eg, breast carcinoma, cervical cancer in situ) that have undergone potentially curative therapy.
Known central nervous system (CNS) metastases and/or carcinomatous meningitis.
Clinically significant cardiac disease within 6 months of first dose of study intervention.
Prolongation of QTc interval to \>480 ms.
Symptomatic pleural effusion (e.g.,cough, dyspnea, pleuritic chest pain) that is not clinically stable.
Pre-existing ≥Grade 3 gastrointestinal or nongastrointestinal fistula.
Moderate to severe hepatic impairment.
History of significant bleeding within 3 months before randomization.
History of solid organ transplantation.
Known psychiatric or substance abuse disorder that would interfere with cooperation with the requirements of the study.
Unable to swallow orally administered medication or has a gastrointestinal disorder affecting absorption (e.g., gastrectomy, partial bowel obstruction, malabsorption).
Known hypersensitivity or allergy to the active pharmaceutical ingredients or any component of the study intervention formulations.
Received colony-stimulating factors \[eg, granulocyte colony-stimulating factor (G-CSF), granulocyte macrophage colony-stimulating factor (GMCSF) or recombinant erythropoietin (EPO)\] within 28 days before randomization.
Prior treatment with belzutifan or another hypoxia-inducible factor (HIF)-2α inhibitor.
Prior treatment with lenvatinib.
Prior treatment with cabozantinib.
Currently participating in a study of an investigational agent or using an investigational device.
Active infection requiring systemic therapy.
History of human immunodeficiency virus (HIV) infection.
History of hepatitis B or known active hepatitis C infection.

Ubicaciones

Centro de Urología (CDU) ( Site 0803)

CABA, Buenos Aires, Argentina

Hospital Británico de Buenos Aires-Oncology ( Site 0801)

Ciudad Autónoma de Buenos Aires, Buenos Aires, Argentina

Instituto Alexander Fleming ( Site 0800)

Ciudad Autónoma de Buenos Aires, Buenos Aires, Argentina

Sanatorio Británico-Clinical Oncology Department ( Site 0802)

Rosario, Santa Fe Province, Argentina

Sanatorio Parque ( Site 0806)

Rosario, Santa Fe Province, Argentina

Asociación de Beneficencia Hospital Sirio Libanés ( Site 0804)

Buenos Aires, Argentina

Estudio abierto, aleatorizado, de fase 3 de MK-6482 en combinación con lenvatinib (MK-7902) frente a cabozantinib en participantes con carcinoma de células renales avanzado que han progresado tras terapia anti-PD-1/L1 previa

Resumen

Elegibilidad

Criterios de inclusión

Criterios de exclusión

Intervenciones

Belzutifan

Lenvatinib

Cabozantinib