CHOUEIRI, T. K., T. POWLES, K. PELTOLA, G. DE VELASCO, M. BUROTTO, C. SUAREZ, P. GHATALIA, R. IACOVELLI, E. T. LAM, E. VERZONI, M. GUMUS, W. M. STADLER, C. KOLLMANNSBERGER, B. MELICHAR, B. VENUGOPAL, M. GROSS-GOUPIL, Alexandr POPRACH, M. DE SANTIS, F. A. SCHUTZ, S. H. PARK, D. A. NOSOV, C. PORTA, J. L. LEE, X. GARCIA-DEL-MURO, E. BISCALDI, R Manneh KOPP, M. OYA, L. HE, A. WANG, R. F. PERINI, D. VICKERY, L. ALBIGES and B. RINI. Belzutifan versus Everolimus for Advanced Renal-Cell Carcinoma. New England Journal of Medicine. Waltham: Massachussetts Medical Society, 2024, vol. 391, No 8, p. 710-721. ISSN 0028-4793. Available from: https://dx.doi.org/10.1056/NEJMoa2313906.
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Basic information
Original name Belzutifan versus Everolimus for Advanced Renal-Cell Carcinoma
Authors CHOUEIRI, T. K., T. POWLES, K. PELTOLA, G. DE VELASCO, M. BUROTTO, C. SUAREZ, P. GHATALIA, R. IACOVELLI, E. T. LAM, E. VERZONI, M. GUMUS, W. M. STADLER, C. KOLLMANNSBERGER, B. MELICHAR, B. VENUGOPAL, M. GROSS-GOUPIL, Alexandr POPRACH (203 Czech Republic, belonging to the institution), M. DE SANTIS, F. A. SCHUTZ, S. H. PARK, D. A. NOSOV, C. PORTA, J. L. LEE, X. GARCIA-DEL-MURO, E. BISCALDI, R Manneh KOPP, M. OYA, L. HE, A. WANG, R. F. PERINI, D. VICKERY, L. ALBIGES and B. RINI.
Edition New England Journal of Medicine, Waltham, Massachussetts Medical Society, 2024, 0028-4793.
Other information
Original language English
Type of outcome Article in a journal
Field of Study 30204 Oncology
Country of publisher United States of America
Confidentiality degree is not subject to a state or trade secret
WWW URL
Impact factor Impact factor: 158.500 in 2022
Organization unit Faculty of Medicine
Doi http://dx.doi.org/10.1056/NEJMoa2313906
UT WoS 001301684200012
Keywords in English Belzutifan; Everolimus; Advanced Renal-Cell Carcinoma
Tags 14110811, rivok
Tags International impact, Reviewed
Changed by Changed by: Mgr. Tereza Miškechová, učo 341652. Changed: 23/9/2024 14:33.
Abstract
Background Belzutifan, a hypoxia-inducible factor 2 alpha inhibitor, showed clinical activity in clear-cell renal-cell carcinoma in early-phase studies. Methods In a phase 3, multicenter, open-label, active-controlled trial, we enrolled participants with advanced clear-cell renal-cell carcinoma who had previously received immune checkpoint and antiangiogenic therapies and randomly assigned them, in a 1:1 ratio, to receive 120 mg of belzutifan or 10 mg of everolimus orally once daily until disease progression or unacceptable toxic effects occurred. The dual primary end points were progression-free survival and overall survival. The key secondary end point was the occurrence of an objective response (a confirmed complete or partial response). Download a PDF of the Plain Language Summary. Results A total of 374 participants were assigned to belzutifan, and 372 to everolimus. At the first interim analysis (median follow-up, 18.4 months), the median progression-free survival was 5.6 months in both groups; at 18 months, 24.0% of the participants in the belzutifan group and 8.3% in the everolimus group were alive and free of progression (two-sided P=0.002, which met the prespecified significance criterion). A confirmed objective response occurred in 21.9% of the participants (95% confidence interval [CI], 17.8 to 26.5) in the belzutifan group and in 3.5% (95% CI, 1.9 to 5.9) in the everolimus group (P<0.001, which met the prespecified significance criterion). At the second interim analysis (median follow-up, 25.7 months), the median overall survival was 21.4 months in the belzutifan group and 18.1 months in the everolimus group; at 18 months, 55.2% and 50.6% of the participants, respectively, were alive (hazard ratio for death, 0.88; 95% CI, 0.73 to 1.07; two-sided P=0.20, which did not meet the prespecified significance criterion). Grade 3 or higher adverse events of any cause occurred in 61.8% of the participants in the belzutifan group (grade 5 in 3.5%) and in 62.5% in the everolimus group (grade 5 in 5.3%). Adverse events led to discontinuation of treatment in 5.9% and 14.7% of the participants, respectively. Conclusions Belzutifan showed a significant benefit over everolimus with respect to progression-free survival and objective response in participants with advanced clear-cell renal-cell carcinoma who had previously received immune checkpoint and antiangiogenic therapies. Belzutifan was associated with no new safety signals. (Funded by Merck Sharp and Dohme, a subsidiary of Merck; LITESPARK-005 ClinicalTrials.gov number, NCT04195750.)
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