Renal cell carcinoma is the most common kidney cancer in adults, accounting for about 90% of kidney cancers. Treatment has changed dramatically in the past decade, with immunotherapy and targeted drugs now often replacing surgery-first approaches for advanced disease. Many people with metastatic kidney cancer now live years longer than was possible a generation ago.
What's actually going on in research
Trials are testing combinations of checkpoint inhibitors with VEGF-blocking drugs, newer targeted therapies that hit multiple pathways, and personalized approaches based on tumor genetics. Researchers are exploring treatments for non-clear cell subtypes, which respond differently than the most common form. Studies are also testing whether imaging or blood tests can detect recurrence earlier than current methods.
Immunotherapy combinations
Pairing drugs like nivolumab or pembrolizumab with cabozantinib or lenvatinib has become standard for many people with advanced disease. Trials are now testing three-drug combinations and looking at whether shorter treatment courses work as well as continuous therapy.
HIF-2α inhibitors
Belzutifan, approved in 2021, targets a protein that helps kidney cancer cells survive in low oxygen. It's showing promise in von Hippel-Lindau disease and is being tested in broader kidney cancer populations.
Non-clear cell RCC
About 25% of kidney cancers aren't the clear cell type, and they respond differently to standard treatments. Trials are testing targeted therapies matched to the specific genetic changes in papillary, chromophobe, and other rare subtypes.
What to know before you search
Eligibility typically depends on disease stage, prior treatments, kidney function, risk category (favorable, intermediate, or poor), and histologic subtype.
What types of trials are currently open
- First-line treatment trials — Testing new drug combinations for people with newly diagnosed advanced kidney cancer, often comparing immunotherapy combinations to see which works best.
- Second-line trials — For people whose cancer has progressed after initial treatment, testing new targeted drugs or immunotherapy approaches.
- Adjuvant trials — Testing whether giving immunotherapy or targeted drugs after surgery reduces the chance of cancer coming back.
- Biomarker studies — Looking at tumor tissue or blood to find markers that predict which treatments will work best for which people.
- Surgery trials — Testing whether partial kidney removal works as well as full removal, or whether ablation techniques can replace surgery in some cases.
Recently added Renal Cell Carcinoma trials
SABR Combined With Axitinib and Toripalimab for Oligometastatic Renal Cell Carcinoma
This is a phase II clinical trial testing whether a combination of stereotactic ablative radiotherapy (SABR), axitinib, and toripalimab is effective and safe for treating oligometastatic clear cell renal cell carcinoma (a type of kidney cancer that has spread to 5 or fewer sites). In this study, all metastatic tumors will be treated with SABR - a precise, high-dose radiation therapy delivered in 5 sessions. At the same time, participants will receive axitinib (an oral targeted cancer drug) twice daily, and toripalimab (an intravenous immunotherapy) every 3 weeks for up to 2 years. The study will enroll 48 participants. The main goal is to measure the objective response rate - the proportion of patients whose tumors shrink or disappear after treatment. Researchers will also track how long patients live without their cancer worsening, overall survival, and any side effects from the treatment. Participants will have regular imaging scans, blood tests, and quality-of-life assessments throughout the treatment and follow-up period.
An MRI-Based Study of Intelligent Pathological Subtyping and Grading of Renal Tumors
This retrospective + prospective, non-interventional study aims to develop and evaluate artificial intelligence methods for the detection, pathological subtyping, and histological grading of renal tumors using magnetic resonance imaging (MRI). Approximately 900 adult patients with available preoperative renal MRI examinations and postoperative pathological results will be included. The pathological findings will be used as the reference standard for model development and evaluation. In addition to MRI data, selected demographic, clinical, and laboratory information may be incorporated to improve model performance. The study will not change participants' diagnosis, treatment, or follow-up, and no additional examinations or interventions will be required. All study data will be de-identified before analysis. The ultimate goal is to develop an MRI-based intelligent diagnostic approach that may assist clinicians in the preoperative assessment and individualized management of patients with renal tumors.
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