Substudy 03B: A Study of Immune and Targeted Combination Therapies in Participants With Second Line Plus (2L+) Renal Cell Carcinoma (MK-3475-03B/KEYMAKER-U03)

NCT ID: NCT04626518

Last Updated: 2025-07-25

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

ACTIVE_NOT_RECRUITING

Clinical Phase

PHASE1/PHASE2

Total Enrollment

370 participants

Study Classification

INTERVENTIONAL

Study Start Date

2020-12-17

Study Completion Date

2026-05-31

Brief Summary

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Substudy 03B is part of a larger research study that is testing experimental treatments for renal cell carcinoma (RCC). The larger study is the umbrella study (U03).

The goal of substudy 03B is to evaluate the safety and efficacy of experimental combinations of investigational agents in participants with advanced second line plus (2L+) clear cell renal cell carcinoma (ccRCC).

This substudy will have two phases: a safety lead-in phase and an efficacy phase. The safety lead-in phase will be used to demonstrate a tolerable safety profile for the combination of investigational agents. There will be no hypothesis testing in this study.

Detailed Description

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Conditions

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Carcinoma, Renal Cell

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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Coformulation Pembrolizumab/Quavonlimab

Participants will receive pembrolizumab/quavonlimab (coformulation of pembrolizumab 400 mg and quavonlimab 25 mg). Pembrolizumab/quavonlimab will be administered intravenously (IV) once every 6 weeks (Q6W) for up to 17 administrations (up to \~2 years).

Group Type EXPERIMENTAL

Pembrolizumab/Quavonlimab

Intervention Type BIOLOGICAL

Administered via IV infusion at a dose of 400 mg/25 mg Q6W

Coformulation Favezelimab/Pembrolizumab

Participants will receive favezelimab/pembrolizumab (coformulation of favezelimab 800 mg and pembrolizumab 200 mg). Favezelimab/Pembrolizumab will be administered IV once every 3 weeks (Q3W) for up to 35 administrations (up to \~2 years).

Group Type EXPERIMENTAL

Favezelimab/Pembrolizumab

Intervention Type BIOLOGICAL

Administered via IV infusion at a dose of 800 mg/200 mg Q3W

Pembrolizumab + MK-4830

Participants will receive pembrolizumab 200 mg PLUS MK-4830 800 mg. Both pembrolizumab and MK-4830 will be administered IV Q3W for up to 35 administrations (up to \~2 years).

Group Type EXPERIMENTAL

Pembrolizumab

Intervention Type BIOLOGICAL

Administered via IV infusion at a dose of 200 mg Q3W or 400 mg Q6W

MK-4830

Intervention Type BIOLOGICAL

Administered via IV infusion at a dose of 800 mg Q3W

Pembrolizumab + Belzutifan

Participants will receive pembrolizumab 400 mg PLUS belzutifan 120 mg. Pembrolizumab will be administered IV Q6W for up to 17 administrations (up to \~ 2 years). Belzutifan will be administered orally once-daily (QD) until progressive disease or discontinuation.

Group Type EXPERIMENTAL

Pembrolizumab

Intervention Type BIOLOGICAL

Administered via IV infusion at a dose of 200 mg Q3W or 400 mg Q6W

Belzutifan

Intervention Type DRUG

Administered via oral tablet at a dose of 120 mg QD

Belzutifan + Lenvatinib

Participants will receive Belzutifan 120 mg PLUS lenvatinib 20 mg. Both belzutifan and lenvatinib will be administered orally QD until progressive disease or discontinuation.

Group Type EXPERIMENTAL

Belzutifan

Intervention Type DRUG

Administered via oral tablet at a dose of 120 mg QD

Lenvatinib

Intervention Type DRUG

Administered via oral capsule at a dose of 20 mg QD

Pembrolizumab + Lenvatinib

Participants will receive pembrolizumab 400 mg PLUS lenvatinib 20 mg. Pembrolizumab will be administered IV Q6W for up to 17 administrations (up to \~2 years). Lenvatinib will be administered orally QD until progressive disease or discontinuation.

Group Type EXPERIMENTAL

Pembrolizumab

Intervention Type BIOLOGICAL

Administered via IV infusion at a dose of 200 mg Q3W or 400 mg Q6W

Lenvatinib

Intervention Type DRUG

Administered via oral capsule at a dose of 20 mg QD

Interventions

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Pembrolizumab

Administered via IV infusion at a dose of 200 mg Q3W or 400 mg Q6W

Intervention Type BIOLOGICAL

MK-4830

Administered via IV infusion at a dose of 800 mg Q3W

Intervention Type BIOLOGICAL

Belzutifan

Administered via oral tablet at a dose of 120 mg QD

Intervention Type DRUG

Lenvatinib

Administered via oral capsule at a dose of 20 mg QD

Intervention Type DRUG

Pembrolizumab/Quavonlimab

Administered via IV infusion at a dose of 400 mg/25 mg Q6W

Intervention Type BIOLOGICAL

Favezelimab/Pembrolizumab

Administered via IV infusion at a dose of 800 mg/200 mg Q3W

Intervention Type BIOLOGICAL

Other Intervention Names

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MK-3475 KEYTRUDA® MK-6482 WELIREG™ MK-7902 E7080 LENVIMA® MK-1308A MK-4280A

Eligibility Criteria

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Inclusion Criteria

* Has a histologically confirmed diagnosis of locally advanced/metastatic clear cell renal cell carcinoma (ccRCC)
* Has experienced disease progression on or after having received systemic treatment for locally advanced or metastatic RCC with a programmed cell death ligand 1 (PD-(L)1) checkpoint inhibitor (in sequence or in combination with a vascular endothelial growth factor. - tyrosine kinase inhibitor \[VEGF-TKI\]) where PD-(L)1 checkpoint inhibitor treatment progression is defined by meeting ALL of the following criteria: (a) has received ≥2 doses of an anti-PD-(L)1 monoclonal antibody (mAb) (b) has shown radiographic disease progression during or after an anti-PD-(L)1 mAb as defined by Response Evaluation Criteria in Solid Tumors version 1.1 (RECIST 1.1) by investigator (c) disease progression has been documented within 12 weeks from the last dose of an anti-PD-(L)1 mAb
* Has experienced disease progression on or after having received systemic treatment for locally advanced or metastatic RCC with a VEGF-TKI (in sequence or in combination with a PD-\[L\]1 checkpoint inhibitor) where VEGF-TKI treatment progression is defined by meeting the following criterion: has shown radiographic disease progression during or after a treatment with a VEGF-TKI as defined by RECIST 1.1 by investigator.
* Is able to swallow oral medication
* Has adequate organ function
* Participants receiving bone resorptive therapy must have therapy initiated at least 2 weeks before randomization/allocation
* Has resolution of toxic effects of prior therapy to ≤Grade 1
* Has adequately controlled blood pressure (BP ≤150/90 mm Hg) with no change in hypertensive medications within 1 week before randomization/allocation
* Male participants are abstinent from heterosexual intercourse or agree to use contraception during treatment with and for at least 7 days after the last dose of lenvatinib and /or belzutifan; 7 days after lenvatinib and/or belzutifan is stopped, if the participant is only receiving pembrolizumab, pembrolizumab/quavonlimab, favezelimab/pembrolizumab, MK-4830 or a combination of the aforementioned drugs, no contraception is needed
* Female participant is not pregnant or breastfeeding and is not a woman of childbearing potential (WOCBP) or is a WOCBP abstinent from heterosexual intercourse or using contraception during the intervention period and for at least 120 days after the last dose of pembrolizumab, pembrolizumab/quavonlimab, favezelimab/pembrolizumab, MK-4830 or 30 days after the last dose of lenvatinib or belzutifan, whichever occurs last and must abstain from breastfeeding during the study intervention period and for at least 120 days after study intervention

Exclusion Criteria

* Has urine protein ≥1 g/24 hours and has any of the following: (a) a pulse oximeter reading \<92% at rest, or (b) requires intermittent supplemental oxygen, or (c) requires chronic supplemental oxygen (d) active hemoptysis within 3 weeks prior to the first dose of study intervention
* Has clinically significant cardiovascular disease within 12 months from the first dose of study intervention administration
* Has had major surgery within 3 weeks before first dose of study interventions
* Has a history of lung disease
* Has a history of inflammatory bowel disease
* Has preexisting gastrointestinal (GI) or non-GI fistula
* Has malabsorption due to prior GI surgery or disease
* Has previously received treatment with a combination of pembrolizumab plus lenvatinib
* Has received prior treatment with belzutifan
* Has received prior radiotherapy within 2 weeks of start of study intervention
* Has received a live or live attenuated vaccine within 30 days before the first dose of study intervention; killed vaccines are allowed
* Has received more than 4 previous systemic anticancer treatment regimens
* Has a diagnosis of immunodeficiency or is receiving any form of immunosuppressive therapy within 7 days prior to the first dose of study intervention
* Has known additional malignancy that is progressing or has required active treatment within the past 3 years
* Has known central nervous system (CNS) metastases and/or carcinomatous meningitis
* Has an active autoimmune disease that has required systemic treatment in the past 2 years; replacement therapy is not considered a form of systemic treatment and is allowed
* Has an active infection requiring systemic therapy
* Has a known history of human immunodeficiency virus (HIV) infection
* Has a known history of Hepatitis B
* Has had an allogenic tissue/solid organ transplant
Minimum Eligible Age

18 Years

Maximum Eligible Age

120 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Merck Sharp & Dohme LLC

INDUSTRY

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Medical Director

Role: STUDY_DIRECTOR

Merck Sharp & Dohme LLC

Locations

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University of California at San Francisco ( Site 3008)

San Francisco, California, United States

Site Status

Yale-New Haven Hospital-Yale Cancer Center ( Site 3011)

New Haven, Connecticut, United States

Site Status

University of Chicago ( Site 3013)

Chicago, Illinois, United States

Site Status

University of Iowa ( Site 3012)

Iowa City, Iowa, United States

Site Status

Henry Ford Health System ( Site 3014)

Detroit, Michigan, United States

Site Status

Laura and Isaac Perlmutter Cancer Center ( Site 3016)

New York, New York, United States

Site Status

Memorial Sloan Kettering Cancer Center ( Site 3002)

New York, New York, United States

Site Status

Duke Cancer Institute ( Site 3015)

Durham, North Carolina, United States

Site Status

UPMC Cancer Center/Hillman Cancer Center ( Site 3017)

Pittsburgh, Pennsylvania, United States

Site Status

Vanderbilt University Medical Center ( Site 3004)

Nashville, Tennessee, United States

Site Status

UTSW Medical Center ( Site 3003)

Dallas, Texas, United States

Site Status

Blacktown Hospital ( Site 3601)

Blacktown, New South Wales, Australia

Site Status

St George Hospital ( Site 3602)

Kogarah, New South Wales, Australia

Site Status

Royal Brisbane and Women's Hospital ( Site 3603)

Herston, Queensland, Australia

Site Status

Austin Health ( Site 3600)

Melbourne, Victoria, Australia

Site Status

Princess Margaret Cancer Centre ( Site 3101)

Toronto, Ontario, Canada

Site Status

Jewish General Hospital ( Site 3100)

Montreal, Quebec, Canada

Site Status

FALP-UIDO ( Site 4100)

Santiago, Region M. de Santiago, Chile

Site Status

Bradfordhill-Clinical Area ( Site 4101)

Santiago, Region M. de Santiago, Chile

Site Status

James Lind Centro de Investigacion del Cancer ( Site 4108)

Temuco, Región de la Araucanía, Chile

Site Status

CIDO SpA-Oncology ( Site 4106)

Temuco, Región de la Araucanía, Chile

Site Status

ONCOCENTRO APYS-ACEREY ( Site 4103)

Viña del Mar, Región de Valparaíso, Chile

Site Status

Institut De Cancerologie De Lorraine ( Site 3204)

Vandœuvre-lès-Nancy, Ain, France

Site Status

Institut de cancérologie Strasbourg Europe (ICANS) ( Site 3203)

Strasbourg, Alsace, France

Site Status

Institut Claudius Regaud ( Site 3200)

Toulouse, Haute-Garonne, France

Site Status

Gustave Roussy ( Site 3202)

Villejuif, Île-de-France Region, France

Site Status

Országos Onkológiai Intézet-Urogenitális Tumorok és Klinikai Farmakológiai Osztály ( Site 4301)

Budapest, Pest County, Hungary

Site Status

Rambam Health Care Campus-Oncology Division ( Site 3500)

Haifa, , Israel

Site Status

Hadassah Medical Center-Oncology ( Site 3504)

Jerusalem, , Israel

Site Status

Rabin Medical Center ( Site 3502)

Petah Tikva, , Israel

Site Status

Sheba Medical Center - Oncology Division ( Site 3501)

Ramat Gan, , Israel

Site Status

Sourasky Medical Center ( Site 3503)

Tel Aviv, , Israel

Site Status

Nederlands Kanker Instituut - Antoni van Leeuwenhoek (NKI-AVL)-medical oncology ( Site 4402)

Amsterdam, North Holland, Netherlands

Site Status

Erasmus Medisch Centrum ( Site 4401)

Rotterdam, South Holland, Netherlands

Site Status

Auckland City Hospital ( Site 3700)

Auckland, , New Zealand

Site Status

Centrum Onkologii im. Prof. Franciszka Lukaszczyka-Ambulatorium Chemioterapii ( Site 4201)

Bydgoszcz, Kuyavian-Pomeranian Voivodeship, Poland

Site Status

Narodowy Instytut Onkologii im. Marii Sklodowskiej-Curie - P-Oddzial Badan Wczesnych Faz ( Site 4200)

Warsaw, Masovian Voivodeship, Poland

Site Status

Uniwersyteckie Centrum Kliniczne-Early Clinical Trials Unit ( Site 4202)

Gdansk, Pomeranian Voivodeship, Poland

Site Status

Asan Medical Center ( Site 3800)

Songpagu, Seoul, South Korea

Site Status

Severance Hospital ( Site 3802)

Seoul, , South Korea

Site Status

Samsung Medical Center ( Site 3801)

Seoul, , South Korea

Site Status

Hospital Universitari Vall d Hebron ( Site 3300)

Barcelona, Catalonia, Spain

Site Status

Hospital Universitario Ramon y Cajal ( Site 3301)

Madrid, , Spain

Site Status

Southampton General Hospital ( Site 3403)

Southampton, England, United Kingdom

Site Status

The Beatson West of Scotland Cancer Centre ( Site 3405)

Glasgow, Glasgow City, United Kingdom

Site Status

Royal Preston Hospital ( Site 3406)

Preston, Lancashire, United Kingdom

Site Status

Leicester Royal Infirmary ( Site 3408)

Leicester, Leicestershire, United Kingdom

Site Status

Barts Health NHS Trust ( Site 3401)

London, London, City of, United Kingdom

Site Status

Western General Hospital ( Site 3402)

Edinburgh, Midlothian, United Kingdom

Site Status

Velindre Cancer Centre Hospital ( Site 3407)

Cardiff, Wales, United Kingdom

Site Status

The Christie NHS Foundation Trust ( Site 3400)

Manchester, , United Kingdom

Site Status

Countries

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United States Australia Canada Chile France Hungary Israel Netherlands New Zealand Poland South Korea Spain United Kingdom

Related Links

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Other Identifiers

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MK-3475-03B

Identifier Type: OTHER

Identifier Source: secondary_id

KEYMAKER-U03

Identifier Type: OTHER

Identifier Source: secondary_id

2023-506839-15-00

Identifier Type: REGISTRY

Identifier Source: secondary_id

U1111-1294-4557

Identifier Type: REGISTRY

Identifier Source: secondary_id

2019-003610-13

Identifier Type: EUDRACT_NUMBER

Identifier Source: secondary_id

3475-03B

Identifier Type: -

Identifier Source: org_study_id

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