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Combining Tivozanib with Pembrolizumab for Kidney Cancer Treatment

Short TeRm Intensified Pembrolizumab (KEytruda) and Tivozanib for High-Risk Renal Cell Carcinoma - STRIKE

Phase 3 Interventional Alliance for Clinical Trials in Oncology · NCT06661720

This study is testing if adding a cancer drug called tivozanib to the immunotherapy pembrolizumab can help people with high-risk kidney cancer live longer and feel better after their surgery.

Quick facts

PhasePhase 3
Study typeInterventional
Enrollment1040 (estimated)
Ages18 Years and up
SexAll
SponsorAlliance for Clinical Trials in Oncology Academic / other
Drugs / interventionsradiation, prednisone, pembrolizumab, Immunotherapy
Locations410 sites (Phoenix, Arizona and 409 other locations)
Trial IDNCT06661720 on ClinicalTrials.gov

What this trial studies

This phase III trial evaluates the effectiveness of adding the anti-cancer drug tivozanib to the immunotherapy pembrolizumab in patients with high-risk renal cell carcinoma (RCC) after surgical removal of the tumor. The study aims to compare disease-free survival and overall survival rates between patients receiving the combination therapy versus those receiving pembrolizumab alone. Participants will undergo regular imaging and blood sample collection to monitor their response to treatment and any adverse effects. The trial also includes objectives to assess quality of life and fatigue levels in patients.

Who should consider this trial

Good fit: Ideal candidates are patients with histologically confirmed clear cell RCC who have undergone complete surgical resection of their primary tumor and are classified as intermediate-high or high-risk.

Not a fit: Patients with non-clear cell RCC or those who have not undergone complete surgical resection of their primary tumor may not benefit from this study.

Why it matters

Potential benefit: If successful, this approach could improve disease-free survival and overall survival rates for patients with high-risk renal cell carcinoma.

How similar studies have performed: Other studies have shown promising results with similar combinations of immunotherapy and targeted therapies, indicating potential for success in this approach.

Eligibility criteria

Show full inclusion / exclusion criteria 
Inclusion Criteria:

* • Histologically confirmed diagnosis of RCC with clear cell component with or without sarcomatoid features following complete resection of the primary tumor (radical or partial nephrectomy)

  * Note: Patients with microscopically positive soft tissue or vascular margins without gross residual disease are permitted

    * Intermediate-high risk RCC:

      * pT2 grade 4 or sarcomatoid features, N0M0
      * pT3 any grade N0, M0
    * High-risk RCC

      * pT4, any grade, N0, M0
      * pT, any stage., any grade, N+, M0
    * cM1 no evidence of disease (NED) RCC

      * Participants who have had resection of primary tumor (radical or partical nephrectomy) and resection or definitive radiation or ablation of solid, isolated, soft tissue metastases (excluding brain and bone lesions) at the time of primary tumor removal (synchronous) or ≤1 year from primary tumor removal (metachronous)

        * Surgery (radical or partial nephrectomy or metastasectomy or ablation) \> 4 weeks but =\< 16 weeks prior to study registration with no ongoing complications from surgery
        * No evidence of disease at time of randomization as assessed by investigator by either CT or MRI scan of the brain and chest, abdomen and pelvis
        * No prior systemic treatment for RCC
        * Age \>= 18 years
        * Eastern Cooperative Oncology Group (ECOG) performance status =\< 2 (or Karnofsky \>= 60%)
        * Absolute neutrophil count (ANC) \>= 1,000/mm\^3
        * Platelet count \>= 100,000/mm\^3
        * Hemoglobin \>= 8 g/dL
        * Total bilirubin =\< 3 x upper limit of normal (ULN)
        * Aspartate aminotransferase (AST) (serum glutamic oxaloacetic transaminase \[SGOT\])/alanine aminotransferase (ALT) (serum glutamate pyruvate transaminase \[SGPT\]) =\< 3 x upper limit of normal (ULN)
        * Calculated (calc.) creatinine clearance \>= 30 mL/min (using Cockcroft Gault equation or the estimated glomerular filtration rate from the modification of diet in renal disease trial)
        * Urine protein =\< 1+ on urine analysis (UA) or urine protein creatinine ration (UPCR) \< 2mg/mg
        * Not pregnant and not nursing, because this study involves an agent that has known genotoxic, mutagenic and teratogenic effects. Therefore, for women of childbearing potential only, a negative pregnancy test is required =\< 14 days prior to registration
        * HIV status: HIV-infected patients on effective anti-retroviral therapy with undetectable viral load within 6 months are eligible for this trial
        * Hepatitis
  * Hepatitis B: For patients with evidence of chronic hepatitis B virus (HBV) infection, the HBV viral load must be undetectable on suppressive therapy, if indicated. Patients with resolved HBV infection, defined as positive hepatitis B core antibody (anti-HBc) and negative hepatitis B surface antigen (HbsAg), are eligible
  * Hepatitis C: Patients with a history of hepatitis C virus (HCV) infection must have been treated and cured. For patients with HCV infection who are currently on treatment, they are eligible if they have an undetectable HCV viral load

    * Cardiac Disease: Patients with known history or current symptoms of cardiac disease, or history of treatment with cardiotoxic agents, should have a clinical risk assessment of cardiac function using the New York Heart Association Functional Classification. To be eligible for this trial, patients should be class IIB or better
    * No history of myocarditis
    * No history of clinically significant pneumonitis
    * No uncontrolled hypertension (systolic blood pressure \[BP\] \> 150 mm Hg or diastolic BP \> 90 mm Hg) documented on 2 consecutive measurements taken at least 2 hours apart
    * No serious non-healing wound, ulcer or bone fracture within 28 days prior to registration
    * No serious/active infection requiring parenteral antibiotics
    * No moderate or severe hepatic impairment (child-Pugh B or C)
    * No significant bleeding disorders within 1 month prior to registration, for example:
  * Hematemesis, hematochezia or other gastrointestinal bleeding grade 3 or higher
  * Hemoptysis of pulmonary bleeding grade 3 or higher
  * Hematuria or other genitourinary bleeding grade 3 or higher

    * No history of allogeneic organ transplantation
    * No history of allergy of hypersensitivity to study drugs or components
    * No condition requiring systemic treatment with either corticosteroid (\> 10 mg daily or prednisone equivalent) within 14 days of treatment initiation or other immunosuppressive medications within 30 days of randomization. Inhaled or topical steroids and adrenal replacement doses ≤10 mg daily prednisone equivalent are permitted in absence of active autoimmune disease
    * No active peptic ulcer disease, inflammatory bowel disease, ulcerative colitis or other gastrointestinal condition associated with increased risk of perforation; history of abdominal fistula, gastrointestinal perforation or intra-abdominal abscess within 4 weeks prior to registration
    * Patients with a prior or concurrent malignancy whose natural history or treatment does not have the potential to interfere with the safety or efficacy assessment of the investigational regimen are eligible for this trial
    * No patients with a history of autoimmune disease that has required systemic treatment in the past 2 years (i.e., with use of disease modifying agents, corticosteroids \> 10 mg/day, or immunosuppressive drugs) with the following exceptions:
  * Replacement therapy (e.g., thyroxine, insulin, physiologic corticosteroid replacement therapy for adrenal or pituitary insufficiency) is not considered a form of systemic treatment and is allowed
  * Brief (\<7 days) use of systemic corticosteroids is allowed when use is considered standard of care
  * Patients with vitiligo, psoriasis, type 1 diabetes mellitus, hypothyroidism, or resolved childhood asthma/atopy will not be excluded
  * Patients requiring intermittent use of bronchodilators, inhaled steroids, or local steroid injections will not be excluded
  * Patients with hypothyroidism that is stable with hormone replacement or Sjögren's syndrome will not be excluded • Chronic concomitant treatment with strong CYP3A4 inducers is not allowed. Patients must discontinue the drug 14 days prior to the start of study treatment

Where this trial is running

Phoenix, Arizona and 409 other locations

+360 more sites — see ClinicalTrials.gov for the full list.

Study contacts

How to participate

  1. Review the eligibility criteria above with your treating physician.
  2. Visit the official trial page on ClinicalTrials.gov for the most current contact information and recruitment status.
  3. Contact the listed study coordinator or principal investigator to request pre-screening. Pre-screening is free and never obligates you to enroll.
View on ClinicalTrials.gov → Find more trials like this →
Conditions Clear Cell Renal Cell CarcinomaRenal Cell CarcinomaStage II Renal Pelvis Cancer AJCC v8Stage III Renal Pelvis Cancer AJCC v8
Last reviewed 2026-06-10 by the Find a Trial editorial team. Information on this page is for educational purposes and is not medical advice. Always consult qualified healthcare professionals about clinical trial participation.