Kidney Cancer Highlights from ASCO 2026
We rounded up a key research highlights from the 2026 American Society of Clinical Oncology meeting, held recently in Chicago, Illinois.
Novel Compounds and Treatment Strategies
Panitumumab could improve survival for renal medullary carcinoma patients
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, led by Dr. Pavlos Msaouel at MD Anderson Cancer Center, 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 – they achieved “complete response”. 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 to understand what they mean for patients. [ASCO 2026, Abstract 4520]
Cadonilimab plus axitinib for first-line non-clear cell kidney cancer treatment
This study from researchers at West China Hospital and Sichuan University in Chengdu, China 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. [ASCO 2026, Abstract 4501]
Apatinib plus camrelizumab may ease surgery in kidney cancers that have 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. [ASCO 2026, Abstract 4536]
Radiotherapy doesn’t help patients with bone metastases more than cabozantinib alone
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. The RADICAL 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. [ASCO 2026, Abstract 4500]
Emotional Health
Patient survey shows how kidney cancer affects emotional well being
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. [ASCO 2026, Abstract 4532]
Feelings of regret linked to long-term side effects rather than cancer recurrence
Pembrolizumab (an immunotherapy infusion) is currently the standard adjuvant treatment (post-surgery) given to patients with clear cell 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. [ASCO 2026, Abstract 4521]
Treatment Selection Methods
ctDNA linked to higher risk of recurrence and successful response to immunotherapy, but with poor accuracy
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. [ASCO 2026, Abstract 4502]
Gene testing can help identify certain patients who will respond best to combined immunotherapy and targeted therapy vs immunotherapy alone
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. [ASCO 2026, Abstract 4546]
TKI-based treatments still most reliable second-line option 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. [ASCO 2026, Abstract 4539]
These summaries were prepared by our partners at the International Kidney Cancer Coalition.