Pembrolizumab plus axitinib versus sunitinib for advanced clear cell renal cell carcinoma: 5-year survival and biomarker analyses of the phase 3 KEYNOTE-426 trial



Summary

The KEYNOTE-426 trial investigated pembrolizumab plus axitinib versus sunitinib for advanced clear cell renal cell carcinoma (ccRCC). After 5 years, the pembrolizumab-axitinib combination demonstrated significantly improved overall survival (OS) and progression-free survival (PFS) compared to sunitinib. Exploratory biomarker analysis revealed associations between higher tumor PD-L1 expression and favorable outcomes with pembrolizumab-axitinib. Additionally, favorable IMmotion151 risk scores and lower pre-treatment absolute neutrophil counts were linked to improved OS in the combination arm. These findings support pembrolizumab plus axitinib as a superior treatment option for advanced ccRCC, with biomarkers potentially aiding in patient selection and risk stratification.

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