In this video, Dr Bradley McGregor from the Dana-Farber Cancer Institute in the US and Dr Rana McKay from UC San Diego Health discuss the health-related quality of life of renal cell carcinoma (RCC) patients on the pembrolizumab plus lenvatinib combination.
The results from the phase 3 CLEAR/KEYNOTE-581 trial with 1069 RCC patients showed significant improvement in survival and response to treatment with the combination compared to the standard of care with sunitinib.
Pembrolizumab plus lenvatinib reduced the risk of the cancer getting worse by 61% and the time to when the cancer started growing again and the treatment stopped working (progression-free survival) was an average of 23.9 months compared to 9.2 months for sunitinib.
The combination reduced the risk of death by 34% versus sunitinib. 73% of patients responded to treatment and their cancer reduced in size versus 36% with sunitinib. 16% of people had a complete response and 55% had a partial response to treatment with pembrolizumab plus lenvatinib compared to 4% and 32% for those on sunitinib.
The patients were put into 3 groups: one group were treated with lenvatinib plus pembrolizumab, another group with lenvatinib plus everolimus, and the third group with sunitinib. Health-related quality of life was assess using three questionnaires, (FKSI-DRS, EORTC QLQ-C30, and EuroQoL EQ-5D-3L), at baseline, on day 1 of each cycle of treatment and when the patient came off treatment. Only quality of life information from patients who had been treated with at least one dose of study medication was analysed.
Patients treated with the lenvatinib plus pembrolizumab combination had better physical function and cancer symptoms, such as tiredness (fatigue), shortness of breath (dyspnoea), and constipation, as well as improved quality of life than patients on sunitinib. However, sunitinib scored better than the lenvatinib plus everolimus combination for overall health-related quality of life, pain, appetite loss, and diarrhoea.