Lenvatinib + pembrolizumab (RCC, 1L)
Deterministic view of the source YAML entity. Clinical authority remains with the cited source IDs and reviewer sign-off state.
Knowledge-base record for audit. Provisional clinical content: this is not a prescription. An oncologist must verify original sources, applicability and review status. Full rules and constraints are in the YAML.
| Components | DRUG-LENVATINIB DRUG-PEMBROLIZUMAB |
|---|
| ID | REG-LENV-PEMBRO-RCC |
|---|---|
| Type | Regimen |
| Status | reviewed 2026-05-03 | pending_clinical_signoff |
| Diseases | None declared |
| Sources | SRC-CLEAR-MOTZER-2021 SRC-ESMO-RCC-2024 SRC-NCCN-KIDNEY-2025 |
Notes
CLEAR: lenv+pembro vs sunitinib, PFS 23.9 vs 9.2 mo (HR 0.39) — largest PFS gain in any 1L ccRCC trial. mOS HR 0.66. However, highest toxicity burden of the 1L combos: hypertension G3-4 ~36%, proteinuria G3 ~6%, fatigue ~10%. Dose reductions frequent (69% for lenvatinib). Max 2 years pembrolizumab. Lenvatinib dose starts at 20mg; reduces to 14→10→8mg for toxicity. Favored when maximal tumor response is the priority (conversion, symptomatic high-burden disease). Use with caution in patients with borderline BP control.
Used By
Indication
IND-RCC-METASTATIC-1L-LENV-PEMBRO- IND-RCC-METASTATIC-1L-LENV-PEMBRO