RecruitingPhase 1Phase 2NCT07049926

Substudy 03C: A Study of Combination Therapies in Participants With Renal Cell Carcinoma With Recurrent Disease During or After Anti-PD-(L)1 Therapy (MK-3475-03C/KEYMAKER-U03)

A Phase 1b/2 Study of Immune and Targeted Combination Therapies in Participants With RCC (KEYMAKER-U03): Substudy 03C in Participants With Recurrent Disease During or After Anti-PD-(L)1 Adjuvant Therapy


Sponsor

Merck Sharp & Dohme LLC

Enrollment

140 participants

Start Date

Jul 20, 2025

Study Type

INTERVENTIONAL

Conditions

Summary

Substudy 03C 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 03C is to evaluate the safety and efficacy of experimental combinations of investigational agents in participants with clear cell renal cell carcinoma (ccRCC) who have recurrent disease during or after anti-programmed cell death 1/programmed cell death ligand 1 (PD-\[L\]1) adjuvant therapy. 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


Eligibility

Min Age: 18 YearsMax Age: 120 Years

Inclusion Criteria8

  • Has a histologically confirmed diagnosis of unresectable locally advanced/metastatic renal cell carcinoma (RCC) with clear cell component
  • Has received no other prior systemic therapy for treatment of advanced/metastatic clear cell renal cell carcinoma (ccRCC) except for adjuvant programmed cell death ligand 1 (PD-(L)1) therapy
  • Has disease recurrence during adjuvant anti- PD-(L)1 therapy or ≤24 months following the last dose of adjuvant anti-PD-(L)1 therapy
  • Is able to swallow oral medication
  • Submits an archival tumor tissue sample or newly obtained core or excisional biopsy of a tumor lesion not previously irradiated
  • Participants receiving bone resorptive therapy (must have therapy initiated at least 2 weeks before allocation/randomization)
  • Has adequately controlled blood pressure (BP) with or without antihypertensive medications, defined as BP ≤140/90 mm Hg with no change in antihypertensive medications within 1 week before allocation/randomization
  • Has adequate organ function

Exclusion Criteria22

  • Has clinically significant hematuria, hematemesis, or hemoptysis of (\>2.5 mL) of red blood, or other history of significant bleeding
  • Has clinically significant cardiovascular disease within 12 months from first dose of study intervention
  • Has deep vein thrombosis within 3 months before allocation/randomization unless stable, asymptomatic, and treated with therapeutic anticoagulation for at least 4 weeks before allocation/randomization
  • Has history of idiopathic pulmonary fibrosis, organizing pneumonia, or evidence of active pneumonitis
  • Has serious wound, ulcer or bone fracture or has had major surgery within 8 weeks before first dose of study intervention
  • Has symptomatic pleural effusion (for example cough, dyspnea, pleuritic chest pain), ascites, or pericardial fluid requiring drainage in the last 4 weeks before allocation/randomization
  • Has gastrointestinal (GI) disorders, including those associated with a high risk of perforation or fistula formation
  • Has malabsorption due to prior GI surgery or GI disease
  • Has moderate to severe hepatic impairment
  • Has received colony-stimulating factors within 28 days prior to intervention allocation/randomization
  • Has received prior radiotherapy within 2 weeks of start of study intervention, or has radiation-related toxicities, requiring corticosteroids
  • Is currently receiving strong inhibitors of cytochrome P450 3A4 (CYP3A4) that cannot be discontinued for the duration of the study
  • Has received a live or live attenuated vaccine within 30 days before the first dose of study intervention
  • Is currently receiving anticoagulants or platelet inhibitors that cannot be discontinued for the duration of the study
  • Have been previously allocated/randomized to study intervention in any sub study of protocol MK-3475-U03
  • Has a known additional malignancy that is progressing or has required active treatment within the past 3 years
  • Has known active central nervous system (CNS) metastases and/or carcinomatous meningitis
  • Has radiographic evidence of encasement or invasion of a major blood vessel, or of intratumoral cavitation
  • Has active autoimmune disease that has required systemic treatment in the past 2 years
  • Has an active infection requiring systemic therapy
  • Has history of human immunodeficiency virus (HIV) infection
  • Has hepatitis B or hepatitis C virus infection

Interventions

DRUGBelzutifan

Oral Tablet

DRUGZanzalintinib

Oral Tablet


Locations(26)

UCSF Medical Center at Mission Bay ( Site 5008)

San Francisco, California, United States

Perlmutter Cancer Center at NYU Langone Hospital - Long Island ( Site 5026)

Mineola, New York, United States

Laura and Isaac Perlmutter Cancer Center ( Site 5016)

New York, New York, United States

Memorial Sloan Kettering Cancer Center ( Site 5002)

New York, New York, United States

Duke Cancer Institute ( Site 5015)

Durham, North Carolina, United States

UPMC Cancer Center/Hillman Cancer Center ( Site 5017)

Pittsburgh, Pennsylvania, United States

Centro de Estudios Clínicos SAGA ( Site 6110)

Santiago, Region M. de Santiago, Chile

Bradfordhill ( Site 6101)

Santiago, Region M. de Santiago, Chile

Institut Claudius Regaud ( Site 5200)

Toulouse, Haute-Garonne, France

Centre Eugene Marquis ( Site 5205)

Rennes, Ille-et-Vilaine, France

Institut De Cancerologie De Lorraine ( Site 5204)

Vandœuvre-lès-Nancy, Meurthe-et-Moselle, France

Gustave Roussy ( Site 5202)

Villejuif, Île-de-France Region, France

Rambam Health Care Campus ( Site 5500)

Haifa, Israel

Rabin Medical Center ( Site 5502)

Petah Tikva, Israel

Sheba Medical Center ( Site 5501)

Ramat Gan, Israel

Sourasky Medical Center ( Site 5503)

Tel Aviv, Israel

Centrum Onkologii im. Prof. Franciszka Lukaszczyka-Ambulatorium Chemioterapii ( Site 6201)

Bydgoszcz, Kuyavian-Pomeranian Voivodeship, Poland

Uniwersyteckie Centrum Kliniczne ( Site 6202)

Gdansk, Pomeranian Voivodeship, Poland

Severance Hospital ( Site 5802)

Seoul, South Korea

Asan Medical Center ( Site 5800)

Seoul, South Korea

Samsung Medical Center ( Site 5801)

Seoul, South Korea

Hospital Universitario Ramon y Cajal ( Site 5301)

Madrid, Madrid, Comunidad de, Spain

Hospital Universitari Vall d'Hebron ( Site 5300)

Barcelona, Spain

Western General Hospital ( Site 5402)

Edinburgh, Edinburgh, City of, United Kingdom

St Bartholomew's Hospital ( Site 5401)

London, London, City of, United Kingdom

The Christie NHS Foundation Trust ( Site 5400)

Manchester, United Kingdom

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NCT07049926


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