The American Society of Clinical Oncology (ASCO) Annual Meeting was held from 29 May-2 June 2026 in Chicago, USA. The presentations are available on the ASCO website. IKCC partner organisations attended the meeting to keep up to date with the care and treatment of kidney cancer patients. A brief ‘Take home messages’ section is followed by more in-depth review of selected abstracts.

Please note: The following summary was prepared for the benefit of patient advocates and patient organisations around the world who focus on kidney cancer. While this summary has been medically reviewed, the information contained herein is based upon public data shared at this meeting and is not intended to be exhaustive or act as medical advice. Patients should speak to their doctor about their own care and treatment.

Take home messages

Abstract 4532 shared IKCC Global Patient Survey 2025 findings: Most people said kidney cancer affected their emotional wellbeing, but many had not discussed these feelings with a healthcare professional or joined a support group. Importance: Patients, carers, and healthcare professionals need better conversations about emotional support, with referrals to counselling, psychological support, and patient organisations.

Abstract 4512 showed that after adjuvant pembrolizumab, patient regret seemed to be linked more to long-term side effects than to the cancer coming back. Importance: Giving clearer information about possible long-term side effects before treatment may help patients make choices that feel right for them.

Abstract LBA4511 presented updated results from the RAMPART study. Durvalumab on its own did not clearly reduce the risk of the cancer coming back after surgery. Importance: It remains unclear whether tremelimumab provides meaningful additional benefit as an adjuvant treatment. Longer follow-up, particularly for overall survival and non-clear cell kidney cancer, is needed.

Abstract 4536 presented early results of a study with neoadjuvant apatinib plus camrelizumab. These results suggest that apatinib plus camrelizumab before surgery may help some patients with kidney cancer that has grown into the vena cava. Importance: It may make surgery possible or easier in some cases. More research is needed to confirm how well this approach works and how safe it is.

Abstract 4502 found that ctDNA testing before and after adjuvant pembrolizumab or placebo did not detect all patients whose cancer later returned. However, ctDNA in the blood was linked to a higher risk of recurrence and was more likely to clear with pembrolizumab than with placebo. Importance: The test may be useful, but it has important limits in kidney cancer.

Abstract 4546 looked at gene changes to see which first treatment for metastatic kidney cancer might work best. Patients with any of the VHL, PBRM1, or BAP1 gene changes may do better with immunotherapy plus a targeted therapy. PD-L1 testing did not help show which treatment was better. Importance: More research is needed before this can guide treatment for patients.

Abstract 4500 showed that adding radium-223 to cabozantinib did not clearly help more than cabozantinib alone in kidney cancer that had spread to the bones. Importance: The combination was safe, but other bone-targeted radiation treatments may need to be studied.

Abstract 4539 showed that TKI-based treatments may be the most reliable second-line option for advanced kidney cancer, especially after immunotherapy. Importance: Other options may still help some patients, but more studies are needed to show the best treatment order.

Abstract 4501 showed that cadonilimab plus axitinib may be a promising first treatment for advanced non-clear cell kidney cancer. Importance: More research is needed to confirm how well it works and how safe it is.

Abstract 4520 suggested that panitumumab may help some people with renal medullary carcinoma after other treatments. Importance: More research is needed, but this could be a step forward for this rare cancer.

Abstract 4521 showed that cabozantinib plus nivolumab may be a useful first treatment for some rarer kidney cancers, especially papillary, unclassified, translocation-related, and FH-deficient types. Importance: More research is needed, but this may be an important option for some patients.

Abstracts 4528 and 4530 showed that cabozantinib plus nivolumab may work better than sunitinib for advanced clear cell kidney cancer, even when the cancer has spread to the liver and/or bones.

Abstract 4550 showed that belzutifan still worked well after 6 years for many people with VHL disease. Importance: These results support belzutifan as an option when tumours do not need immediate surgery.

Abstract 4561 showed that belzutifan worked in everyday care much as it did in clinical trials. Importance: Some health and blood test results were linked to outcomes, but more research is needed before they can guide care.

Abstract 4555 showed that tivozanib alone may be a useful treatment after earlier immunotherapy for advanced kidney cancer. Importance: Adding nivolumab did not appear to give extra benefit, and tivozanib’s side effects remained in line with what doctors already know.

Summaries

IKCC Global Patient Survey 2025

Abstract 4532: Emotional health concerns due to kidney cancer and unmet needs in patient support

Kidney cancer can strongly affect how patients feel. Support services are an important part of care because they can help people cope and improve their wellbeing. Since 2018, the IKCC and its partners have done a worldwide survey every 2 years to understand how kidney cancer affects people, how it is diagnosed and treated, what support is needed, and how experiences differ between countries. This report shares global results from the 2025 survey about emotional wellbeing and the support used by patients and carers.

The survey was created by a team of patient advocates, doctors and experts. The survey was for kidney cancer patients and their carers. It was translated into 16 languages and could be completed online or on paper.

2,677 people from 46 countries took part in the survey between 24 September and 15 November 2025 – 2,049 patients and 628 carers.

Overall, more than 8 in 10 people (85%) said kidney cancer had affected them emotionally, no matter what stage of the disease they were at. The most common feelings were worry about the disease (half of the people), fear that it might come back (half), sadness or depression (one third), and fear of dying (one third). People aged 66 and over reported fewer emotional concerns than younger people.

Across countries, 4 in 10 people (40%) to two thirds (66%) said they had talked with a healthcare professional about their feelings. These talks were more common in India and Mexico, and least common in the Republic of Korea. Many people also said these conversations did not help enough. For example, a third of people (33%) said it was not helpful when talking about problems finding their way through the healthcare system.

Overall, half of the people had used a patient support group, either in person or online. Use was lowest in Japan (2 in 10 people, 19%), Türkiye (a quarter, 24%), France (a quarter, 25%), and Italy (a quarter, 27%), and highest in India (9 in 10 people, 90%) and the Republic of Korea (9 in 10 people, 88%). Nearly half (47%) said support groups were helpful. The most helpful resources were patient organisation websites (nearly 3 in 10 people, 28%) and online support groups (nearly 3 in 10 people, 27%), although this varied by country. People also said they wanted more counselling, more face-to-face support, more support from other patients, and more online support.

Most people who answered the survey said kidney cancer had affected their emotional wellbeing. However, many had not spoken to a healthcare professional about these feelings or taken part in a support group, either in person or online. Patients, carers, and healthcare professionals need better conversations about emotional support. Healthcare professionals can help by referring patients to counselling, psychological support, and patient organisations in their own country.

Treatment given before or after surgery for high-risk kidney cancer

Surgery (nephrectomy) is the standard of care for large, high-risk kidney cancers that have not spread outside the kidney. The cancer can come back (recurrence) after nephrectomy in some patients. Adjuvant therapy is additional treatment that is given after surgery to reduce the risk of the cancer from coming back.

Trials with targeted therapies that block the blood supply to the cancer have shown little benefit for patients for stopping the cancer from coming back after surgery.

However, immunotherapy with pembrolizumab has been approved in several countries as an adjuvant therapy to stop the cancer from coming back in other parts of the body.

Abstract 4512: How patients feel about their treatment decision and side effects after pembrolizumab given after surgery for kidney cancer

Pembrolizumab (an immunotherapy infusion) is currently the standard adjuvant treatment given to patients with clear cell renal cell carcinoma (RCC) (the most common type of kidney cancer) who are at higher risk of their cancer coming back after their kidney tumour has been removed. This study wanted to find out whether people later felt unhappy about choosing this treatment, and whether that was linked to long-term side effects. The researchers used a new tool, designed with patients, to better understand side effects that may have a big impact on daily life.

104 kidney cancer patients who had pembrolizumab after surgery were included in the study. They answered questions about whether they regretted having treatment, their side effects, and whether their cancer had come back. Doctor’s records were compared to what patients reported.

Patients were followed for 2 and a half years on average. Slightly more than 1 in 10 patients (14%) had their cancer come back. Nearly 2 in 10 patients (18%) had severe immune-related side effects. But patients often felt the impact of these side effects was greater, and nearly 3 in 10 (28%) said their side effects were important and 1 in 10 (11%) said they were life changing. In a third of cases, side effects that were graded as mild or moderate by the doctor were described as important by the patient.

Overall, just over 1 in 10 patients (13%) regretted their treatment decision. Regret was more common in people who had life-changing or important side effects, especially permanent hormone problems or muscle and joint problems. Patients who expected fewer side effects before treatment were also more likely to regret their decision later.

After adjuvant pembrolizumab, regret seemed to be linked more to long-term side effects than to the cancer coming back. Tools designed with patients may be better at showing which side effects matter most in everyday life. Giving clearer information about possible long-term side effects before treatment may help patients make choices that feel right for them.

Abstract LBA 4511: Adjuvant durvalumab compared to active monitoring for kidney cancer in the RAMPART study

The RAMPART study looked at two immunotherapies called durvalumab and tremelimumab for the treatment of patients with kidney cancer. Durvalumab was given on its own (monotherapy) or in combination with tremelimumab to patients with kidney cancer who had their cancer surgically removed (nephrectomy). This is called adjuvant therapy.

The main aim of this study was to find out how effective durvalumab, either alone or with tremelimumab, is at stopping kidney cancer from spreading and returning after surgery.

Early results showed that giving patients durvalumab and tremelimumab after their kidney cancer had been removed by surgery helped stop the cancer from coming back, especially for those who had the highest risk of their cancer returning. At ASCO 2026, results were presented for patients treated with adjuvant durvalumab given on its own and compared to active monitoring.

790 patients joined the study from the UK, France, Australia, and Spain. At 3 years, nearly 8 in 10 patients (78%) who had durvalumab alone were alive without their cancer coming back, compared with just more than 7 in 10 patients (72%) who had active monitoring alone. This difference was not strong enough to clearly show that durvalumab on its own was better. This was different from an earlier result in the same study, where the combination of durvalumab plus tremelimumab showed clearer benefit.

The side effects seen in this study were mostly what doctors already know about these treatments. However, a few rare serious immune-related side effects were reported, including inflammation of the heart muscle and a condition that causes severe muscle weakness (myasthenia gravis). Some of these side effects were life-threatening.

After 15 months, there was no clear difference in overall health and quality of life between patients who had durvalumab alone, durvalumab plus tremelimumab, or active monitoring.

In the RAMPART study, durvalumab on its own did not clearly reduce the risk of the cancer coming back after surgery. Earlier results suggested that the combination of durvalumab plus tremelimumab may be more helpful. However, it remains unclear whether tremelimumab provides meaningful additional benefit compared to durvalumab alone as an adjuvant treatment. Longer follow-up, particularly for overall survival and non-clear cell kidney cancer, is needed.

Abstract 4536: Can apatinib plus camrelizumab before surgery help people with kidney cancer that has grown into the vena cava?

Sometimes, anti-cancer medication is given before surgery to shrink the kidney tumour to make it easier to remove. This is called neoadjuvant treatment.

Kidney cancer that has grown into a large vein near the kidney (the vena cava) can be difficult to remove with surgery. This study looked at whether giving apatinib (a targeted therapy) plus camrelizumab (an immunotherapy) before surgery could help shrink the cancer or make surgery easier.

This early study included patients with kidney cancer that could still be removed with surgery but had also grown into the vena cava. Patients received camrelizumab by drip every 2 weeks and took apatinib tablets every day before surgery. The researchers mainly looked at whether the growth in the vein became smaller or easier to remove. They also looked at how the main kidney tumour responded, side effects, and early survival results.

Nine patients took part in the study. In 4 patients, the growth in the vein became smaller, and in 8 patients the cancer stayed under control. In 3 patients, the growth in the vein reduced enough to lower its stage, and all 3 then had surgery. Overall, 7 of the 9 patients completed treatment and went on to have surgery. The kidney tumour itself shrank in 1 patient and stayed stable in the others. Side effects were manageable, although some patients had more serious problems such as high blood pressure, protein in the urine, lung inflammation, and a rare nerve-related side effect.

These early results suggest that apatinib plus camrelizumab before surgery may help some patients with kidney cancer that has grown into the vena cava. It may make surgery possible or easier in some cases. More research is needed to confirm how well this approach works and how safe it is.

Biomarkers for kidney cancer

A biomarker is something in your blood, urine, or tissue that can be measured to give doctors information about your health. In cancer, it might be a protein or a change in the cancer genes. Biomarkers may help doctors diagnose cancer, predict how well a treatment might work, and understand what may happen in the future.

For kidney cancer, doctors still mainly rely on the cancer stage, grade, type, and the person’s overall health. Currently, no biomarker test can reliably show how someone will respond to treatment. A useful biomarker could help doctors choose the best treatment for each patient.

Abstract 4502: ctDNA analysis in patients with kidney cancer treated with adjuvant pembrolizumab or placebo in the KEYNOTE-564 study

The KEYNOTE-564 study showed that pembrolizumab (an immunotherapy infusion) after surgery helped some patients with clear cell kidney cancer more than placebo (a dummy treatment), especially those at higher risk of the cancer coming back. At ASCO 2026, researchers presented the results of looking at cancer DNA in the blood to see if this could help show who was more likely to do well after treatment.

The researchers tested the blood samples from kidney cancer patients for tiny traces of cancer, called ctDNA (circulating tumour DNA). They wanted to see whether finding ctDNA before treatment with pembrolizumab, or seeing it change during treatment, was linked to whether the cancer stayed away.

There were 994 patients in the study, half had pembrolizumab and half had placebo. ctDNA was tested in 736 patients before treatment and again later in 641 patients. Patients were followed for an average of more than 5 and a half years. At the start of the study, ctDNA was found in only a small number of patients (less that 1 in 10 patients). It was more common in patients with higher risk cancer. In both the pembrolizumab and placebo groups, patients with ctDNA in their blood at the start of the study were more likely to have their cancer come back. The test missed many patients whose cancer later returned, but it was better at showing who was less likely to have a recurrence. In those patients who had a later ctDNA test, ctDNA was more likely to disappear with pembrolizumab treatment than with placebo.

In conclusion, the ctDNA blood test could not identify everyone whose cancer came back later. However, when ctDNA was found in the blood, it was linked to a higher chance of the cancer returning. ctDNA was more likely to disappear with pembrolizumab than with placebo. This suggests the test may be helpful, but there are still important limits with this type of cancer.

Abstract 4546: Can blood and tumour tests help doctors choose the best first treatment for advanced kidney cancer?

This study looked at two common first treatments for advanced clear cell kidney cancer: two immunotherapy medicines together, or immunotherapy plus a targeted therapy. Researchers wanted to know whether changes in certain cancer genes or a protein called PD-L1 could help show which treatment might work better for different patients.

The researchers looked at the health records of more than 4,800 patients in from the United States. They included adults with advanced clear cell kidney cancer who started first treatment with either ipilimumab plus nivolumab, or an immunotherapy plus a targeted therapy, such as nivolumab plus cabozantinib, pembrolizumab plus axitinib, or pembrolizumab plus lenvatinib. They also looked at tumour test results and blood markers, then compared how long patients lived and how long their cancer stayed under control.

Just over 1,000 patients received one of these first treatments. In a smaller group of patients who had gene testing, those with changes in the VHL, PBRM1, or BAP1 genes generally did better with immunotherapy plus targeted therapy than with ipilimumab plus nivolumab. Their cancer stayed under control for longer. In the overall group, the differences between the two treatment types were smaller. PD-L1 testing did not clearly help show which treatment was better.

This study suggests that some gene changes may help doctors choose between two common first treatments for advanced kidney cancer. Patients with any of the VHL, PBRM1, or BAP1 gene changes may do better with immunotherapy plus targeted therapy. PD-L1 testing did not help show which treatment was better. More research is still needed before this can guide treatment decisions for everyone.

Promising new treatments for advanced/metastatic kidney cancer

Currently, the most effective first-line treatment for patients with advanced kidney cancer is a combination of immunotherapy and targeted therapy (e.g., nivolumab plus cabozantinib) or a combination of immunotherapies (e.g., nivolumab plus ipilimumab). These combination therapies have significantly improved patient outcomes.

Some patients have a complete response to these treatments, characterised by the total regression of all metastases. For instance, approximately 9% of patients treated with nivolumab plus cabozantinib experience complete response. Ongoing research is focused on identifying new treatments that can increase complete tumour response.

Abstract 4500: Can radium-223 and cabozantinib help people with kidney cancer that has spread to the bones? The RADICAL study

Cancer that has spread to the bones happens in about 3 in 10 people with advanced kidney cancer and can cause pain and other serious bone problems. This study looked at whether adding radium-223 to cabozantinib could help people with kidney cancer that had spread to the bones. Radium-223 is a treatment that targets cancer in the bones and is already used for some people with advanced prostate cancer.

The study included 90 patients with kidney cancer that had spread to the bones and was causing symptoms. They were put into 2 groups at random. One group received cabozantinib plus radium-223. The other group received cabozantinib alone. The researchers wanted to see whether adding radium-223 could delay serious bone-related problems, such as fractures or the need for treatment to the bones. They also looked at side effects, tumour shrinkage, how long the cancer stayed under control, and overall survival.

The study found that adding radium-223 did not clearly reduce serious bone-related problems compared with cabozantinib alone. Tumour shrinkage was similar in both groups. Side effects were common in both groups, and severe side effects happened in more than half of patients. The combination was considered safe overall, but the study was stopped early because it was unlikely to show a clear benefit.

In this study, adding radium-223 to cabozantinib did not clearly help patients more than cabozantinib alone for the main outcome the researchers were measuring. The combination was safe enough to use, but other bone-targeted radiation treatments may need to be studied in kidney cancer.

Second-line treatments for advanced/metastatic kidney cancer

Treatments for advanced kidney cancer have improved a lot over the past 10 years. But for most people, the cancer eventually starts growing again, so new treatments are still needed.

In many countries, the first treatment for advanced kidney cancer is a combination of immunotherapy and a targeted therapy called a TKI. This works better than a TKI alone, but doctors still do not know which treatment is best once the cancer starts growing again.

Abstract 4539: Sequencing of second-line treatment for advanced kidney cancer.

Doctors still do not know for sure which treatment is best after the first treatment stops working in advanced kidney cancer. This study brought together results from earlier clinical trials to compare second-line treatment options.

The researchers reviewed 13 studies involving about 5,000 patients with advanced kidney cancer. These studies looked at treatments given after earlier targeted therapy or immunotherapy. The researchers grouped the treatments into main types, such as tyrosine kinase inhibitors (TKIs, e.g., cabozantinib, sunitinib, axitinib, pazopanib), mTOR inhibitors (e.g., everolimus), immunotherapy-based treatments, and immunotherapy/targeted therapy combinations, and then compared how well they worked across the studies.

Overall, TKI-based treatments gave the most consistent benefit. They helped patients live longer and helped keep the cancer under control for longer. Immunotherapy/targeted therapy combinations also helped delay cancer growth, but they did not clearly help patients live longer. mTOR inhibitors gave less benefit overall, and results with immune-based treatments were more mixed. When the researchers focused on patients who had already had immunotherapy as their first treatment, TKI-based treatments still appeared to be the most reliable second option.

This review suggests that TKI-based treatments may currently be the most reliable second-line option for advanced kidney cancer, especially after first treatment with immunotherapy. Other treatment types may still help some patients, but the results were less consistent. More studies are needed to show the best order for using these treatments.

Treatments for non-clear cell RCC

Non-clear cell RCC is a rare group of cancers comprising over 20 types of kidney cancer. They account for about 20–25% of kidney cancer diagnoses. Patients with these cancers typically have shorter survival compared to those with clear cell RCC. Their rarity makes it difficult to conduct large treatment studies, so the best treatments are uncertain and improved options are needed. In general, these cancers do not respond as well to immunotherapy as clear cell kidney cancer.

Abstract 4501: Can cadonilimab plus axitinib help as a first treatment for advanced non-clear cell kidney cancer?

This study looked at whether a new combination of cadonilimab (an immunotherapy infusion) and axitinib (a targeted therapy) could help people with advanced non-clear cell kidney cancer.

This was an early study of 37 people with advanced non-clear cell kidney cancer that could not be removed with surgery or had already spread. All patients received cadonilimab together with axitinib as their first treatment. The researchers mainly looked at safety and how many patients had their tumours shrink.

In this early study, about half of the patients had their tumours shrink with treatment, and almost all had their cancer stay the same or get smaller for some time. Patients lived for an average of about 17 months before the cancer started growing again. Side effects were common, and just over half of patients had serious treatment-related side effects, but these were considered manageable.

These early results suggest that cadonilimab plus axitinib may be a promising first treatment for advanced non-clear cell kidney cancer. The treatment showed encouraging activity, but more research in larger studies is needed to confirm how well it works and how safe it is.

Abstract 4520: Can panitumumab help treat a rare type of kidney cancer called renal medullary carcinoma (RMC)?

Renal medullary carcinoma (RMC) is a very rare and fast-growing type of kidney cancer. It most often affects younger people who carry the sickle cell gene. Usual kidney cancer treatments often do not work well for RMC, and standard chemotherapy has only limited benefit. This study looked at whether panitumumab, a treatment that blocks epidermal growth factor receptor (EGFR), a protein that controls cell growth, division, and survival, could help people with RMC.

The researchers first studied tumour samples in the laboratory to see whether EGFR was active in RMC. They then tested panitumumab in the laboratory and compared it with another EGFR drug called erlotinib. They also looked at results from 26 patients with RMC from several countries who received panitumumab, either on its own or together with chemotherapy, after earlier treatments had stopped working.

The laboratory studies showed that EGFR was strongly active in these tumours, and panitumumab worked better than erlotinib in the laboratory tests. In the group of 26 patients, just over half had their tumours shrink, including 4 patients whose tumours could no longer be seen on scans. On average, the cancer stayed under control for nearly 6 months. Treatment side effects were generally manageable. The most common side effect was a skin rash, and there were no treatment-related deaths.

These early results look promising, but more research is needed before we can be sure what they mean for patients.

Abstract 4521: Can cabozantinib plus nivolumab help people with non-clear cell kidney cancer?

This study looked at cabozantinib (a targeted therapy) plus nivolumab (an immunotherapy) in people with advanced non-clear cell kidney cancer, which is a less common group of kidney cancers. Earlier results from a smaller number of patients looked promising, and this update reports the final results from all 60 patients in the study.

The study included people with advanced non-clear cell kidney cancer who had either not had treatment before or had received one earlier treatment, but not immunotherapy. Everyone received cabozantinib tablets together with nivolumab infusions. The researchers grouped patients by the type of non-clear cell kidney cancer they had, including papillary, unclassified, translocation-related, and chromophobe kidney cancer. They then looked at how many tumours shrank, how long the cancer stayed under control, how long patients lived, and side effects.

Of the 60 patients in the study, most had papillary, unclassified, or translocation-related kidney cancer. In these groups, about 4 in 10 patients had their tumours shrink, and the results were especially strong in patients with a type of tumour called FH-deficient. On average, the cancer stayed under control for about 11 months, and patients lived for about 28 months. In the small group of patients with chromophobe kidney cancer, no tumours shrank, although some patients had their cancer stay stable for a time. Side effects were similar to earlier reports, and some patients had to stop cabozantinib or nivolumab because of side effects.

These final results suggest that cabozantinib plus nivolumab may be a useful first treatment for some people with advanced non-clear cell kidney cancer, especially papillary, unclassified, translocation-related, and FH-deficient types. It did not appear to work as well in chromophobe kidney cancer. More research is still needed, but this treatment may be an important option for some of these rarer cancers.

Updated results from studies of treatments for advanced kidney cancer

Abstracts 4528 and 4530: Can cabozantinib plus nivolumab work better than sunitinib for advanced kidney cancer that has spread to the bones or liver? The CheckMate 9ER study

These analyses looked at results from the CheckMate 9ER study, which compared cabozantinib (a targeted therapy) plus nivolumab (an immunotherapy) with sunitinib (a targeted therapy) as a first treatment for advanced clear cell kidney cancer. The researchers wanted to know how well these treatments worked in people whose cancer had spread to the liver and/or bone, and whether the results were similar when the cancer had also spread to other parts of the body.

In the main study, 651 patients with advanced clear cell kidney cancer were put into 2 treatment groups at random. One group received cabozantinib plus nivolumab, and the other received sunitinib. In this analysis, the researchers looked more closely at patients whose cancer had spread to the liver and/or bones, and at some who also had cancer in the lungs, lymph nodes, or adrenal glands.

Of the 651 patients, 129 had cancer that had spread to the liver and 154 had cancer that had spread to the bones at the start of the study. In patients with or without liver and/or bone spread, cabozantinib plus nivolumab helped people live longer without their cancer getting worse and improved overall survival compared with sunitinib. More patients also had their tumours shrink, and their responses lasted longer. Outcomes were generally poorer for patients whose cancer had spread to the liver, especially if it had also spread to the bones, but the combination treatment still worked better than sunitinib across these groups.

Side effects in patients with liver and/or bone spread were like those seen in the full study.

These results suggest that cabozantinib plus nivolumab may be a better first treatment than sunitinib for advanced clear cell kidney cancer, even when the cancer has spread to the liver and/or bones. The benefit was also seen in patients whose cancer had spread to other organs as well.

Abstract 4550: Can belzutifan help people with von Hippel-Lindau disease over the long term? Six years follow up from the LITESPARK-004 study

Von Hippel-Lindau (VHL) disease is an inherited condition that can cause tumours and cysts in different parts of the body, including the kidneys, brain, eyes, and pancreas. Belzutifan is a targeted treatment that is already used for some people with VHL disease whose tumours do not need immediate surgery. This study looked at how well belzutifan worked and how safe it was after at least 6 years of follow-up.

The study included 61 people with VHL disease who had at least one kidney tumour that could be measured but did not need surgery straight away. They had not had cancer drug treatment before. Everyone took belzutifan tablets once a day. The researchers looked at how many tumours shrank, how long the treatment kept working, and what side effects happened. They also looked at tumours in other parts of the body linked to VHL disease.

All 61 patients received belzutifan, and just over half were still taking it after about 6 years of follow-up. The treatment helped shrink kidney tumours in 7 out of 10 patients. It also helped shrink tumours in the brain and pancreas, and all eye tumours that were checked showed improvement. Fewer patients needed surgery or radiation after starting belzutifan than in the years before treatment.

Serious side effects happened in about 2 in 10 patients, most often anaemia. No life-threatening treatment-related side effects were reported.

After 6 years of follow-up, belzutifan still appeared to work well for many people with VHL disease and helped control tumours in different parts of the body. Its side effects were considered manageable. These results support belzutifan as a treatment option for patients with VHL disease whose tumours do not need immediate surgery.

Abstract 4561: Real-world survival with belzutifan treatment for advanced kidney cancer

Belzutifan is a new treatment for advanced kidney cancer after earlier treatments have stopped working. Earlier studies have suggested it could help patients more than everolimus. This study looked at how well belzutifan worked in everyday clinical practice and whether certain health factors were linked to better or worse outcomes.

The researchers looked back at the health records from patients with advanced kidney cancer who were treated with belzutifan after earlier treatments had stopped working. They then looked at how long patients lived after starting treatment and whether any health or blood test results at the start of treatment were linked to better or worse survival.

The study included 2,844 patients. Overall, the results were like those seen in the earlier LITESPARK-005 study, which supports belzutifan as a useful treatment option in real-world care. About 8 in 10 patients were alive 6 months after starting treatment, and just over half were alive at 2 years.

Some health and blood test results were linked to outcomes. In general, patients did better when they had better overall health and nutrition at the start of treatment. Smoking and signs of inflammation or other health problems were linked to worse survival. These findings may help doctors better understand which patients are likely to do well with belzutifan.

This large real-world study suggests that belzutifan works in everyday care much as it did in clinical trials. Some routine health and blood test results were linked to better or worse outcomes, but more research is needed before these can be used to guide care for individual patients.

Abstract 4555: Can tivozanib help people with advanced kidney cancer after earlier treatment? Final results from the TiNivo-2 study

Earlier results from the TiNivo-2 study showed that adding nivolumab to tivozanib did not help patients more than tivozanib alone after earlier immunotherapy treatment for advanced kidney cancer. At ASCO 2026, researchers presented the longer-term results to better understand how well these treatments worked over time and how safe they were.

Patients with advanced kidney cancer were put into 2 groups at random. One group received tivozanib (a targeted therapy) on its own. The other group received tivozanib together with nivolumab (an immunotherapy). The researchers looked at how long patients lived, how long the cancer stayed under control, and what side effects happened.

More than 340 patients took part in the study. In people having second-line treatment, tivozanib on its own helped keep the cancer under control for longer than tivozanib plus nivolumab. However, overall survival was similar between the 2 groups.

No new safety concerns were seen with longer follow-up. The most common serious side effect in both groups was high blood pressure. Diarrhoea and soreness or redness of the hands and feet were less common. A small number of patients in both groups had serious side effects linked to treatment.

These final results suggest that tivozanib on its own may be a useful treatment option after earlier immunotherapy for advanced kidney cancer. Adding nivolumab did not appear to give extra benefit. Tivozanib continued to show a safety profile that doctors already know well.

Acknowledgements:

Editor: Dr I Park (KR)

Medical Reviewers: Professor Stênio de Cássio Zequi (BR)

Professor Axel Bex (NL/UK)

Medical Writer: Dr Sharon Deveson Kell (UK)