Kidney cancer treatment has shifted toward combinations of immunotherapy and targeted pills for advanced disease, with many patients living years longer than they would have a decade ago. For early-stage tumors, partial-kidney surgery and ablation are increasingly replacing full removal.
What's actually going on in research
Trials are testing immunotherapy combinations after surgery to prevent recurrence, treatments for non-clear-cell subtypes that have had fewer options, and HIF-2 alpha inhibitors — a newer drug class effective in advanced disease and in patients with VHL syndrome. Research also focuses on biomarkers that predict who responds to which treatment.
Immunotherapy combos
Combinations of two immunotherapies or one with a targeted pill are now standard for advanced kidney cancer. Trials are testing them after surgery to lower recurrence.
HIF-2 alpha inhibitors
A new class of pills blocks a key driver of clear-cell kidney cancer. Belzutifan is approved, and newer drugs in this class are in trials.
Kidney-sparing surgery
For small tumors, removing just the cancer instead of the whole kidney preserves kidney function long term. Trials are also studying ablation as an even less invasive option.
What to know before you search
Eligibility often depends on subtype (clear cell most common), stage, prior treatments, and sometimes inherited conditions like von Hippel-Lindau syndrome.
What types of trials are currently open
- Treatment trials — Testing new drugs or combinations in people with kidney cancer to see if they extend life or shrink tumors more than standard care.
- Adjuvant trials — Testing treatments given after surgery to lower the chance the cancer comes back.
- Surgical trials — Comparing partial-kidney removal, full removal, and ablation procedures for early-stage tumors.
- Observational studies — Following people with kidney cancer to understand outcomes and identify markers that predict response.
- Supportive care trials — Testing ways to manage fatigue, blood pressure, and other side effects of long-term targeted therapy.
Recently added Kidney Cancer trials
A Smart Phone Application to Improve Adoption of the 2024 Kidney Disease Improving Global Outcomes (KDIGO) Chronic Kidney Disease (CKD) Guidelines
The goal of this study is to establish whether use of a digital intervention can improve adherence and alignment with the Kidney Disease: Improving Global Outcomes (KDIGO) Chronic Kidney Disease (CKD) 2024 Guidelines. A subset of the study will focus on whether the intervention improves outcomes for young adults living with CKD, in the context of the imminent co-location of Children's Health Ireland on the St. James's Hospital campus. Young adults with CKD transitioning to adult services are recognised as a high-risk and vulnerable cohort, with many individuals unaware of increased cardiovascular risk and mortality¹². In response, and in the context of the co-location of Children's Health Ireland on the St. James's Hospital site, a young adult nephrology clinic has been established. The KDIGO CKD 2024 Guidelines identify transition as a period of increased risk and include recommendations regarding cardiovascular risk factor targets and the use of therapies known to delay CKD progression³. Electronic communication is a preferred method for accessing health information among many young adults⁴⁵ and aligns with Sláintecare digital health strategies⁶. A recently established, award-winning St. James's Hospital renal smartphone application is currently used by over 3,000 individuals living with CKD. The study aims to determine whether use of the application improves adherence to KDIGO guideline recommendations, with the objective of delaying CKD progression and associated complications. The application will support optimisation of care by signposting opportunities for evidence-based interventions (e.g., SGLT2 inhibitors, renin-angiotensin system inhibition) to healthcare providers. The application will also provide participants with tailored recommendations, reminders, educational materials, and collection of patient-reported outcome measures. Due to the diverse population and range of specialties at St. James's Hospital, the young adult clinic serves distinct subgroups, including individuals with sickle cell anaemia and survivors of cancer and haematological malignancies. These populations will be examined in the context of KDIGO guideline implementation, contributing to a limited international evidence base. This research evaluates an intervention designed to improve care for adults living with chronic kidney disease.
Pilot Study of Bone Mineral Density Changes During Anti-PD-1 Immunotherapy
Immune checkpoint inhibitors (ICIs) have revolutionized cancer treatment and work by blocking protein interactions that normally prevent the immune system from recognizing and destroying cancer cells. However, these agents, now approved for over 15 types of cancers and for both early-stage and metastatic disease, are capable of causing inflammation in any organ system of the body that can lead to organ damage, dysfunction, and even death in rare cases. Some patients may suffer acute and treatable complications like joint pain, but some may have irreversible complications like hypothyroidism that requires daily, life-long medication. It is therefore important to fully understand the different types of damage ICIs can cause to better monitor patients receiving ICI therapy. A rising concern from recent reports in the literature is that ICIs may weaken bone and increase the risk of fractures. In this study, the investigators aim to characterize how ICIs impact the bone by examining several factors in patients undergoing curative-intent ICI treatment either alone or in combination with chemotherapy: bone mineral density, bone volume, and markers of bone turnover in the blood. The study will use two imaging techniques to assess bone mineral density and volume. DXA (dual X-ray absorptiometry) imaging uses low-dose X-rays to measure how dense (or strong) bones are and is often used to diagnose or assess the risk of osteoporosis. High-resolution peripheral quantitative computed tomography (HRpQCT) is a 3D imaging technology that can quantify bone structure and volume and offers high resolution that can be used to assess bone in smaller bones of the peripheral skeleton. The investigators hypothesize that ICI treatment will weaken bones and increase the risk of fractures. As ICI therapy is relatively new, a rising number of patients may be at risk of fractures or have low bone density that is not being monitored because there are no guidelines in place notifying physicians of this potential risk to patients. This is study will provide important preliminary data that will be the basis for larger studies in the future aiming to better monitor and potentially treat bone weakening in patients treated with ICIs to reduce the pain, inconvenience, and complications from fragility fractures.
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