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Renal Cell CarcinomaPhase 2MoonlandingNCT07593040

Pembrolizumab Plus Belzutifan With or Without Lenvatinib in Localized Renal Cell Carcinoma

A Phase 2 study testing Neoadjuvant Pembrolizumab, Belzutifan and Lenvatinb in people with Renal Cell Carcinoma, run by Vall d'Hebron Institute of Oncology at 14 sites in Spain.

Not yet recruiting

Opening soon. The study is approved but enrolment has not started yet. Sites may already take enquiries.

Sites and contacts
Official record
Search all trials

Trial summary

This study is designed to evaluate the efficacy of belzutifan in combination with pembrolizumab with or without lenvatinib in the neoadjuvant setting, followed by adjuvant pembrolizumab versus adjuvant pembrolizumab alone, as treatment for participants with intermediate-high and high risk clear cell renal cell… Read more about this study

Who is it for?
Ages 18 years and older
Conditions the study is for
Renal Cell Carcinoma
What is being tested?
Neoadjuvant Pembrolizumab, Belzutifan and Lenvatinb
Could I receive a placebo?
No, everyone receives an active treatment
How many people
150 participants
Where
14 sitesSpain
Study dates
Jun 2026to Jun 2031
Phase
Phase 2
Are there results?
Not yet: the study is under way

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 years and older
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Male/female participants who are at least 18 years of age on the day of signing informed consent.
  • 2. Willing to provide written informed consent. They may also provide consent for Future Biomedical Research; however, the participant may participate in the main trial without participating in the Future Biomedical Research.
  • 3. Histologically confirmed diagnosis of RCC with a clear cell component with or without sarcomatoid features. Diagnosis is to be made by the investigator and does not require central histology review.
  • 4. Tumours must be T2 with grade 4, T3, T4, or any T with N1, M0 on radiographic imaging using TNM staging (8th edition)
  • T2 is defined as a tumour >7cm but limited to the kidney; grade 4 is per the International Society of Urological Pathology (ISUP) grading.
  • T3 is defined as tumour extension into major veins or perinephric tissues, but not into ipsilateral adrenal gland or beyond Gerota's fascia.
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  • T4 is defined as a tumour involving the ipsilateral adrenal gland or invading beyond Gerota's fascia.
  • N1 is defined as metastatic involvement of regional lymph nodes. 5. Archival tumour tissue sample or newly obtained core, incisional, or excisional biopsy of a tumour lesion not previously irradiated has been provided. Formalin-fixed, paraffin embedded (FFPE) tissue blocks are preferred to slides. Newly obtained biopsies are preferred to archived tissue.
  • 6. Have an Eastern Cooperation Oncology Group (ECOG) Performance Status of 0 to 1.
  • Evaluation of ECOG is to be performed within 14 days prior to the first dose of study intervention.
  • 7. Have been considered suitable for curative intent surgery (partial or total nephrectomy), as evaluated by a surgeon. 8. Have adequately controlled blood pressure (BP) with or without antihypertensive medications, defined as BP ≤150/90 mm Hg.
  • 9. Have adequate organ function as defined in the following table (Table 7). Specimens must be collected within 14 days prior to the start of study intervention.
  • 10.Participants agree to the contraception guidelines outlined in section 5.1.3.2.
  • 11.Participants who are HBsAg positive are eligible if they have received hepatitis B virus (HBV) anti-viral therapy for at least 4 weeks and have undetectable HBV viral load prior to randomization.
  • Note: Participants should remain on anti-viral therapy throughout study intervention and follow local guidelines for HBV anti-viral therapy post completion of study intervention.
  • Hepatitis B screening tests are not required unless:
  • Known history of HBV infection As mandated by local health authority 12.Participants with a history of hepatitis C virus (HCV) infection are eligible if HCV viral load is undetectable at screening.
  • Note: Participants must have completed curative anti-viral therapy at least 4 weeks prior to randomization.
  • Hepatitis C screening tests are not required unless:
  • Known history of HCV infection As mandated by local health authority 13.HIV-infected participants must have well-controlled HIV on antiretroviral therapy (ART), defined as:
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  • Participants on ART must have a CD4+ T-cell count ≥350 cells/mm3 at the time of screening.
  • Participants on ART must have achieved and maintained virologic suppression defined as confirmed HIV RNA level below 50 or the lower limit of quantification (LLOQ) (below the limit of detection) using the locally available assay at the time of screening and for at least 12 weeks before screening
  • It is advised that participants must not have had any AIDS-defining opportunistic infections within the past 12 months.
  • Participants on ART must have been on a stable regimen, without changes in drugs or dose modification, for at least 4 weeks before study entry (Day 1) and agree to continue ART throughout the stud

Who cannot join

  • 1. Has evidence of metastatic disease on screening imaging. 2. Has received prior therapy with an anti-PD-1, anti-PD-L1, or anti-PD-L2 agent or with an agent directed to another stimulatory or co-inhibitory T-cell receptor (e.g., CTLA-4, OX-40, CD137).
  • 3. Has received prior systemic anti-cancer therapy including investigational agents within 3 years prior to randomization.
  • 4. Known additional malignancy that is progressing or has required active treatment within the past 3 years. Note: Participants with basal cell carcinoma of the skin, squamous cell carcinoma of the skin or carcinoma in situ, excluding carcinoma in situ of the bladder, that have undergone potentially curative therapy are not excluded.
  • Participants with low-risk early-stage prostate cancer either treated with definitive intent or untreated in active surveillance with stable disease are not excluded.
  • 5. Has received a live vaccine or live-attenuated vaccine within 30 days before the first dose of study intervention. Administration of killed vaccines is allowed. COVID-19 and influenza vaccinations are allowed provided they are not live vaccines 6. Has received an investigational agent or has used an investigational device within 4 weeks prior to study intervention administration.
  • 7. Has a diagnosis of immunodeficiency or is receiving chronic systemic steroid therapy (in dosing exceeding 10 mg daily of prednisone equivalent) or any other form of immunosuppressive therapy within 7 days prior to the first dose of study drug 8. Has severe hypersensitivity (≥Grade 3) to pembrolizumab and/or any of its excipients, and/or lenvatinib, and/or belzutifan.
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  • 9. Has active autoimmune disease that has required immunosuppressive systemic treatment in the past 2 years except replacement therapy (e.g., thyroxine, insulin, or physiologic corticosteroid).
  • 10.Has a history of (non-infectious) pneumonitis/interstitial lung disease that required steroids or has current pneumonitis/interstitial lung disease11.Has any of the following:
  • A pulse oximeter reading <92% at rest, or
  • Requires intermittent supplemental oxygen, or
  • Requires chronic supplemental oxygen. 12.Has an active infection requiring systemic intravenous therapy. 13.Has moderate to severe hepatic impairment (Child-Pugh B or C). 14.Concurrent active Hepatitis B (defined as HBsAg positive and/or detectable HBV DNA) and Hepatitis C virus (defined as anti-HCV Ab positive and detectable HCV RNA) infection.
  • Note: Hepatitis B and C screening tests are not required unless:
  • Known history of HBV and HCV infection
  • As mandated by local health authority
  • 15.Has urine protein ≥1 g/24 hours.
  • Note: Participants with proteinuria ≥2+ (≥100 mg/dL) on urine dipstick testing (urinalysis) will undergo 24-hour urine collection for quantitative assessment of proteinuria.
  • Note: Urine dipstick is the preferred method for testing urinary protein, however, urinalysis may be used if the use of urine dipsticks is not feasible.
  • 16.Has had major surgery within 3 weeks prior to first dose of study interventions.
  • Note: Adequate wound healing after major surgery must be assessed clinically, independent of time elapsed for eligibility 17.Has a history or current evidence of any condition, therapy, or laboratory abnormality or other circumstance that might confound the results of the study, interfere with the participant's participation for the full duration of the study, such that it is not in the best interest of the participant to participate, in the opinion of the treating investigator.
  • 18.Has known psychiatric or substance abuse disorders that would interfere with cooperation with the requirements of the trial.
  • 19.Is pregnant or breastfeeding or expecting to conceive or father children within the projected duration of the study, starting with the screening visit through 120 days after the last dose of trial treatment.
  • 20.Has had an allogenic tissue/solid organ transplant. 21.Has preexisting ≥Grade 3 gastrointestinal or non-gastrointestinal fistula22.Has a left ventricular ejection fraction (LVEF) below the institutional (or local laboratory) normal range, as determined by multigated acquisition (MUGA) or echocardiogram (ECHO).
  • 23.Prolongation of QTcF interval to >480 ms. 24.Has clinically significant cardiovascular disease within 12 months from first dose of study intervention, including New York Heart Association Class III or IV congestive heart failure, unstable angina, myocardial infarction, cerebral vascular accident, or cardiac arrhythmia associated with hemodynamic instability. Note: Medically controlled arrhythmia would be permitted.
  • 25.Active hemoptysis (bright red blood of at least 0.5 teaspoon) within 3 weeks prior to the first dose of study drug.
  • 26.Gastrointestinal malabsorption or any other condition that might affect the absorption of lenvatinib 27.Is currently receiving either strong (phenobarbital, enzalutamide, phenytoin, rifampicin, rifabutin, rifapentine, carbamazepine, nevirapine and St John's Wort)

Trial locations and contacts

14 sites in 1 country. Contact the study team or a site near you to ask about taking part.

Cristina Suárez, Dr contact

+34 932543450

csuarez@vhio.net

14 sites in 1 country

Spain14 sites
  • Hospital Universitari Vall D Hebron

    Barcelona, Catalonia, 08035

    Cristina Suárez, Dr, +34 932543450, csuarez@vhio.net

    Cristina Suárez, Dr

  • Hospital Clinic De Barcelona

    Barcelona, Catalonia, 08036

    Oscar Reig, Dr, +34 932275402, oreig@clinic.cat

    Oscar Reig, Dr

  • Hospital Universitario Reina Sofia

    Córdoba, Andalusia, 14004

    Mª José Méndez, Dr, +34 957010380, mjosemv@yahoo.es

    Mª José Méndez, Dr

  • Institut Catala D'oncologia

    L'Hospitalet de Llobregat, Catalonia, 08908

    Mayra Lizbeth Orrillo, Dr, +34 932607136, mayralizbethorrillo@iconcologia.net

    Mayra Lizbeth Orrillo, Dr

  • Hospital Universitario Lucus Augusti

    Lugo, Galicia, 27003

    Sergio Vazquez, Dr, +34 982296459, Sergio.Vazquez.Estevez@sergas.es

    Sergio Vazquez, Dr

  • Hospital Universitario Ramon Y Cajal

    Madrid, Madrid, 28034

    Javier Molina, Dr, +34 913368897, javier.molinace@gmail.com

    Javier Molina, Dr

  • Hospital Universitario 12 De Octubre

    Madrid, Madrid, 28041

    Guillermo de Velasco, Dr, +34 913908547, gdvelasco.gdv@gmail.com

    Guillermo de Velasco, Dr

  • Complejo Hospitalario Universitario De Ourense

    Ourense, Galicia, 32005

    Ovidio Fernandez, Dr, +34 986217450, ovidiofernandezcalvo@yahoo.es

    Ovidio Fernandez, Dr

  • Hospital Universitario Central De Asturias

    Oviedo, Principality of Asturias, 33011

    Carlos Alvarez, Dr, +34 985108000, carlos.alvfer@gmail.com

    Carlos Alvarez, Dr

  • Hospital Universitario De Navarra

    Pamplona, Navarre, 31008

    Nuria Lainez, Dr, +34 848422222, Nuria.lainez.milagro@cfnavarra.es

    Nuria Lainez, Dr

  • Parc Tauli Hospital Universitari

    Sabadell, Catalonia, 08208

    Enrique Gallardo, Dr, +34 937240084, egallardo@tauli.cat

    Enrique Gallardo, Dr

  • Hospital Universitario Marques De Valdecilla

    Santander, Cantabria, 39008

    Ignacio Durán, Dr, +34 942315515, ignaciojose.duran@scsalud.es

    Ignacio Durán, Dr

  • Hospital Universitario Y Politecnico La Fe

    Valencia, Valencia, 46026

    Regina Girones, Dr, +34 961244674, girones_reg@gva.es

    Regina Girones, Dr.

  • Hospital Clinico Universitario Lozano Blesa

    Zaragoza, Aragon, 50009

    Julio Lambea, Dr, +34 976765769, juliolambea@yahoo.es

    Julio Lambea, Dr

Other trials in Spain

About this study

Official title: A Randomized Phase 2 Trial of Neoadjuvant Pembrolizumab Plus Belzutifan With or Without Lenvatinib in Patients With Localized Renal Cell Carcinoma

This study is designed to evaluate the efficacy of belzutifan in combination with pembrolizumab with or without lenvatinib in the neoadjuvant setting, followed by adjuvant pembrolizumab versus adjuvant pembrolizumab alone, as treatment for participants with intermediate-high and high risk clear cell renal cell carcinoma (ccRCC).

Being tested
Neoadjuvant Pembrolizumab, Belzutifan, Lenvatinb
Medical subject headings
Carcinoma, Renal Cell

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Neoadjuvant PembrolizumabDrug

    400mg q6w of Pembrolizumab will be administered before nephrectomy in cohorts A and B

  • BelzutifanDrug

    120mg daily for 12w of Belzutifan will be administered before nephrectomy in Cohorts A and B

  • LenvatinbDrug

    20mg daily for 12 weeks of lenvatinib will be administered before nephrectomy in Cohort A

Study groups in NCT07593040
Study groupRoleWhat they receive
Cohort AExperimentalNeoadjuvant therapy with Pembrolizumab (400mg q6w) + Lenvatinib (20mg daily for 12w) + Belzutifan (120mg daily for 12w). Followed by nephrectomy and pembrolizumab (400mg q6w for 9 months)
Receives: Drug: Neoadjuvant Pembrolizumab; Drug: Belzutifan; Drug: Lenvatinb
Cohort BExperimentalNeoadjuvant therapy with Pembrolizumab (400mg q6w) + Belzutifan (120mg daily for 12w). Followed by nephrectomy and pembrolizumab (400mg q6w for 9 months)
Receives: Drug: Neoadjuvant Pembrolizumab; Drug: Belzutifan
Cohort CActive comparatorNephrectomy folloewd by pembrolizumab (400mg q6w for 12 months)
Receives: Drug: Neoadjuvant Pembrolizumab

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Response Rate

    Radiographic response defined as a decrease of initial tumour size ≥30% from baseline to week 12 CT scan

    Measured: At 12 weeks from start of treatment

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted18 May 2026
  2. Study startJun 2026 (estimated)
  3. Primary completionJan 2028 (estimated)
  4. Study completionJun 2031 (estimated)

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase 2
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Crossover
Model description
This study is a randomized, multi-arm, open label design to evaluate the efficacy of belzutifan in combination with pembrolizumab with or without lenvatinib in the neoadjuvant setting, followed by adjuvant pembrolizumab versus adjuvant pembrolizumab alone, as treatment for participants with intermediate-high and high risk clear cell renal cell carcinoma (ccRCC), defined as T2 with grade 4, T3, T4, or TxN1, M0 disease
Masking
None (open label)
Enrolment
150 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT07593040
Sponsor's protocol ID
VHIO24002
Other IDs
2024-519673-18-00
Acronym
Moonlanding
Status last verified
Nov 2025
First submitted
11 May 2026
Last updated
20 May 2026
Results posted
No
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
Undecided

Questions about this trial

What is this clinical trial studying?

A Phase 2 study testing Neoadjuvant Pembrolizumab, Belzutifan and Lenvatinb in people with Renal Cell Carcinoma, run by Vall d'Hebron Institute of Oncology at 14 sites in Spain.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 25 inclusion and 25 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: opening soon, as of the sponsor's last update on 20 May 2026. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 14 sites in Spain. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

What does this phase mean?

Phase 2 studies give the treatment to a larger group to see whether it has the intended effect and to keep checking safety.

Not every study follows the same path, and some studies (observational studies, device studies) have no phase.

Are results available for this study?

This study is still under way. Results are not available in the source record yet.

How can a doctor refer a patient or contact the research team?

Contact Cristina Suárez, Dr (+34 932543450, csuarez@vhio.net), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Response Rate (time frame: At 12 weeks from start of treatment). It is what the study was designed to measure, not a finding.

Where can I read the original study information?
Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 20 May 2026.

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