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The Use of Lenvatinib and Pembrolizumab in the Treatment of Advanced Kidney Cancer

The Use of Lenvatinib and Pembrolizumab in the Treatment of Advanced Kidney Cancer

Kidney cancer, also known as renal cell carcinoma (RCC), is one of the most common types of cancer affecting the kidneys. It is estimated that over 73,000 new cases of kidney cancer will be diagnosed in the United States in 2021 alone. Advanced kidney cancer refers to cases where the cancer has spread beyond the kidneys to other parts of the body, making it more challenging to treat. However, recent advancements in targeted therapies and immunotherapies have revolutionized the treatment landscape for advanced kidney cancer.

Lenvatinib and pembrolizumab are two drugs that have shown promising results in the treatment of advanced kidney cancer. Lenvatinib is a targeted therapy that works by inhibiting the growth of blood vessels that supply nutrients to the tumor, thereby starving it of essential resources. Pembrolizumab, on the other hand, is an immunotherapy that helps the body’s immune system recognize and attack cancer cells.

In 2019, a groundbreaking clinical trial called CLEAR (Combination Lenvatinib and Pembrolizumab for Advanced Renal Cell Carcinoma) demonstrated the efficacy of combining lenvatinib and pembrolizumab in the treatment of advanced kidney cancer. The trial involved over 1,000 patients with previously untreated advanced RCC and compared the combination therapy to sunitinib, a standard targeted therapy for kidney cancer.

The results of the CLEAR trial were highly encouraging. The combination therapy of lenvatinib and pembrolizumab significantly improved progression-free survival (PFS) compared to sunitinib. PFS refers to the length of time during and after treatment that a patient lives without their disease worsening. The median PFS for patients receiving lenvatinib and pembrolizumab was 23.9 months, compared to 9.2 months for those receiving sunitinib.

Furthermore, the combination therapy also demonstrated a higher objective response rate (ORR), which measures the percentage of patients whose tumors shrink or disappear completely. The ORR for lenvatinib and pembrolizumab was 71%, compared to 36% for sunitinib. These results highlight the superior efficacy of the combination therapy in achieving tumor shrinkage and control.

In addition to improved efficacy, the combination therapy also showed a manageable safety profile. The most common side effects observed were hypertension, diarrhea, fatigue, and decreased appetite. However, these side effects were generally manageable with appropriate medical intervention and did not outweigh the benefits of the treatment.

Based on the positive results from the CLEAR trial, the U.S. Food and Drug Administration (FDA) approved the combination therapy of lenvatinib and pembrolizumab as a first-line treatment for advanced kidney cancer in 2021. This approval provides a new and effective treatment option for patients with this challenging disease.

It is important to note that not all patients may be eligible for this combination therapy. Healthcare professionals will consider various factors such as overall health, previous treatments, and specific genetic mutations in the tumor before recommending the most appropriate treatment approach.

In conclusion, the use of lenvatinib and pembrolizumab in the treatment of advanced kidney cancer has shown remarkable efficacy and safety in clinical trials. This combination therapy offers improved progression-free survival and objective response rates compared to standard targeted therapies. The FDA approval of this treatment regimen marks a significant milestone in the management of advanced kidney cancer, providing hope for patients and healthcare professionals alike. Continued research and advancements in targeted therapies and immunotherapies hold promise for further improving outcomes in the future.