[Slide 1]
Summary and Conclusions
Belzutifan + lenvatinib demonstrated superior PFS and ORR VS cabozantinib in participants
with OS favored belzutifan + lenvatinib but did not reach statistical significance and will be tested
advanced clear cell RCC following anti-PD-(L)1 therapy
further The safety at final profile analysis of belzutifan + lenvatinib was generally consistent with the profiles of the
individual to worsening drugs in disease-specific symptoms and quality of life were similar between
belzutifan + is the first phase 3 study of a HIF-2a inhibitor to show improved plus a VEGFR-TKI, outcomes and VS a the
Time lenvatinib VS cabozantinib
LITESPARK-011 phase 3 study in RCC in the post-PD-(L)1 setting new
contemporary first VEGFR-TKI addresses unmet clinical need and anti-PD-(L)1 represents a therapy potential
treatment Belzutifan option + lenvatinib for patients with RCC an that progressed after
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[Slide 2]
Primary Endpoint: PFS per RECIST 1.1 by BICR
100
12 months
24 months
Belzutifan +
Cabozantinib
Lenvatinib
90
(N = 376)
(N = 371)
80
Events, n (%)
232 (62.5)
273 (72.6)
Progression-free survival, %
70
Median, mo
14.8
10.7
55.0%
(95% CI)
(11.2-16.6)
(9.2-11.1)
60
50
HR 0.70, 95% CI 0.59-0.84,
35.6%
40
1-sided P =.00007*
30
41.0%
20
10
19.1%
0
0
5
10
15
20
25
30
35
40
45
50
No. at Risk
Months
Belzutifan +
371
292
204
151
117
61
39
19
8
1
0
Lenvatinib
Cabozantinib 376
279
166
102
78
33
10
2
0
0
0
denotes statistical significance (1-sided boundary 0.0047).
Data cutoff date, IA2: 9 April 20
[Slide 1]
Secondary Endpoint: DOR per RECIST 1.1 by BICR
Belzutifan +
100
12 months
24 months
Cabozantinib
Lenvatinib
90
(N = 371)
(N = 376)
Pts with
80
195
151
response, n
66.7%
70
Median DOR,
23.0 (2.0 to 44.3+)
12.3 (1.8+ to 35.9+)
Duration of response, %
mo (range)
60
49.5%
50
40
50.0%
30
20
25.5%
10
0
0
5
10
15
20
25
30
35
40
45
50
No. at Risk
Months
Belzutifan +
195
179
135
101
66
42
29
8
4
0
0
Lenvatinib
Cabozantinib 151
136
79
58
34
15
5
1
0
0
0
DOR, duration of response.
Data cutoff date, IA2: 9 April 2025
---
[Slide 2]
Summary of Treatment Exposure and Safetya
Belzutifan +
Belzutifan +
Cabozantinib
Cabozantinib
Treatment-emergent AEs
Lenvatinib
Treatment-related AEs
Lenvatinib
(N = 371)
(N = 371)
(N = 370)
(N = 370)
Median duration of therapy,
16.8
13.2
Pts with AE, n (%)
mo (range)
(0.03-46.9)
(0.4-41.9)
Any
361 (97.6)
363 (97.8)
Pts with AE, n (%)
Grade 23
265 (71.6)
244 (65.8)
Any
369 (99.7)
369 (99.5)
Serious
98 (26.5)
63 (17.0)
Grade >3
311 (84.1)
307 (82.7)
Led to death
2 (0.5)
1 (0.3)
Serious
191 (51.6)
163 (43.9)
Led to dose reduction of:
VEGFR-TKI
246 (66.5)
288 (77.6)
Belzutifan
125 (33.8)
NA
Led to discontinuation of:
All study drugs
41 (11.1)
42 (11.3)
Belzutifan
62 (16.8)
NA
VEGFR-TKI
78 (21.1)
42 (11.3)
Reported for the as-treated population, defined as all randomized pts who received at dose of study treatment
Treatment-related AEs that led to death were thrombotic microangiopathy (n=1) and pneumonitis (n=1) in the belzutifan lenvatinib arm,
and hemoplysis (n=1) in the cabozantinib arm.
Data cutoff date, IA2: 9 April 2025
---
[Slide 3]
Common Treatment-Emergent AEsᵃ
Incidence >20% in Any Arm
Belzutifan + Lenvatinib (N = 370)
Cabozantinib (N = 371)
Diarrhea
52.7%
70.1%
Hypertension
58.9%
56.6%
Anemia
69.2%
25.6%
Fatigue
45.1%
40.7%
Decreased appetite
39.2%
40.4%
Nausea
40.5%
38.5%
PPES
20.5%
51.2%
Hypothyroidism
35.7%
28.0%
Weight decreased
28.1%
29.4%
Proteinuria
36.8%
19.4%
AST increased
21.1%
33.7%
ALT increased
18.9%
31.0%
AEs of clinical interest and incidence <20% with
Constipation
26.2%
22.6%
belzutifan . lenvatinib vs cabozantinib included:
Asthenia
28.4%
20.2%
Hypoxia all grade: 15.4% vs 0%
Vomiting
31.4%
16.2%
Grade 23: 11.9% vs 0%
Arthraigia
28.9%
16.7%
Cardiac dysfunction all grade: 7.0% vs 1.1%
Stomatitis
14.1%
28.0%
Grade 23: 4.6% vs 0.5%
Dysgeusia
12.4%
27.8%
Headache
22.2%
12.4%
100
80
60
40
20
0
20
40
60
80
100
Incidence, %
Any grade AEs
Grade >3 AEs
Any grade AEs
Grade >3 AEs
ALT. alanine aminotransferase; AST, aspartate aminotransferase; PPES, palmar-plantar erythrodysesthesia syndrome.
"Collected up to 30 days after cessation of study treatment.
Data cutoff date, IA2: 9 April 2025
---
[Slide 4]
Summary and Conclusions
Belzutifan + lenvatinib demonstrated superior PFS and ORR vs cabozantinib in participants
with advanced clear cell RCC following anti-PD-(L)1 therapy
OS favored belzutifan + lenvatinib but did not reach statistical significance and will be tested
further at final analysis
The safety profile of belzutifan + lenvatinib was generally consistent with the profiles of the
individual drugs
Time to worsening in disease-specific symptoms and quality of life were similar between
belzutifan + lenvatinib vs cabozantinib
LITESPARK-011 is the first phase 3 study of a HIF-2a inhibitor plus a VEGFR-TKI, and the
first phase 3 study in RCC in the post-PD-(L)1 setting to show improved outcomes vs a
contemporary VEGFR-TKI
Belzutifan + lenvatinib addresses an unmet clinical need and represents a potential new
treatment option for patients with RCC that progressed after anti-PD-(L)1 therapy
[Slide 1]
ASCO
"This is a positive trial, and I think it will be
meaningful for patients. The combination
met its PFS primary endpoint. The high ORR
from the TKI helps de-risk the regimen,
while belzutifan may drive more durable
responses-with the understanding that
patient selection and toxicity monitoring
remain critical."
Dr. Katy Beckermann
Tennessee Oncology
Positions belzutifan + lenvatinib as a potential new standard in advanced ccRCC after PD-1/PD-L1 inhibitor therapy — directly challenging single-agent cabozantinib (current SOC in this setting). Expands role of HIF-2α inhibition beyond VEGF-TKI-refractory monotherapy.
Median PFS was 14.8 months with belzutifan + lenvatinib (95% CI 11.2-16.6) vs. 10.7 months with cabozantinib (9.2-11.1); HR 0.7 (0.59-0.84, P=0.00007). Median follow-up 29.0 months.
Trend toward OS benefit at interim analysis: HR 0.85 (95% CI 0.68-1.05, P=0.06075). Not yet statistically significant; final OS pending further follow-up.
✅ Two sNDAs filed — potential new SOC in post-IO advanced ccRCC. Positions belzutifan + lenvatinib as a potential new standard in advanced ccRCC after PD-1/PD-L1 inhibitor therapy — directly challenging single-agent cabozantinib (current SOC in this setting). Expands role of HIF-2α inhibition beyond VEGF-TKI-refractory monotherapy.