Kidney Cancer Highlights from 2026 ASCO GU
We rounded up a few research highlights from the 2026 ASCO Genitourinary Cancers Symposium (ASCO GU), held recently in San Francisco, California.
Altitude can affect oxygen-related side effects from belzutifan
The approval of the hypoxia-inducible factor (HIF-2a) belzutifan by the FDA offered a new treatment option for kidney cancer patients that harnessed the cellular mechanism by which cells can adapt to environments with different levels of oxygen. HIF-2a is what allows this oxygen response pathway and its activity is known to be disrupted in renal cell carcinoma (RCC).
This study from researchers at the Huntsman Cancer Institute at the University of Utah in Salt Lake City, including the Kidney Cancer Association’s Clinical Advisory Board member Julia Batten, APRN, MSN, MPH, is the first to report safety data on a group of metastatic renal cell carcinoma patients living at high altitude and treated with belzutifan.
This retrospective study included 34 metastatic RCC (mRCC) patients treated with belzutifan. Patients with germline Von Hippel-Lindau (VHL) syndrome, the most common hereditary kidney cancer syndrome, were excluded. The altitude at which they lived was estimated using US Geologic Survey data. The researchers measured blood oxygen saturation to determine hypoxia (insufficient oxygen supply to body tissues) and whether they required supplemental oxygen. They compared these findings with reports of hypoxia as an adverse event and supplemental oxyten use in the LITESPARK-005 trial data, which was the basis for approving belzutifan to treat mRCC.
“The high incidence of hypoxia and use of supplemental oxygen among our high-altitude patient population is in stark contrast to LITESPARK-005 trial data,” the researchers wrote. “In that trial, the rate of hypoxia of any grade was only 14.5% with 10.2% needing supplemental oxygen.”
The researchers found that 88% of patients in their high-altitude study experienced hypoxia as an adverse event – the most common was hypoxia at grade 3, which is significant – and at-home supplemental oxygen was required by 82% of patients. Patients also experienced higher-grade anemia (79%).
The researchers estimated that LITESPARK-005 participants lived at an average elevation of 201 meters. The Huntsman trial participants lived at an average residential altitude of 1,457 meters.
An estimated 943 million people worldwide live above 1000 meters in elevation.
“Upon external validation, these findings may support future guidelines on closer monitoring and earlier intervention for patients with mRCC receiving belzutifan who reside at high altitudes,” the researchers wrote. [2026 ASCO GU, Abstract 488]
More YES1 proteins on kidney tumors may indicate treatment resistance
Our immune system can turn itself off at various checkpoints to protect healthy cells from destruction. Immune checkpoint inhibitors help pump the brakes on these pathways through various surface proteins and administering these drugs are what allow the immune system to continue working to better destroy cancerous cells.
YES1 is a type of protein that is present in greater quantities on clear cell kidney cancer cells especially in patients who have become resistant to treatment, which happens often, making it a potential biomarker for identifying treatment resistant patients, according to primary investigator Dr. Mitchell Hayes, a urologic oncology fellow at Moffitt Cancer Center who received a Kidney Cancer Association Research Award in 2024 supporting this research.
In a batch of 209,255 cells from a group of 11 kidney cancer patients treated with immunotherapy, tyrosine kinase inhibitor targeted therapy, or both, YES1 was present more often among immunotherapy patients compared with a group of 21 kidney cancer patients who had not been treated with anything.
Analysis of a group of patients from a larger study showed higher YES1 protein expression on tumor cell surfaces was associated with worse overall survival among a subgroup of 69 patients treated with immunotherapy but not 69 patients treated with targeted therapy. The researchers also found seven additional genes of proteins that are known to interact with YES1 were correlated within tumor cells and present in greater quantities in patients who had received immunotherapy. [2026 ASCO GU, Abstract 522]
No extra toxicity with higher doses of live bacteria product that enhances immunotherapy activity
CBM588 is a live bacterial product that has the potential to interact with our gut bacteria – the gut microbiome – and clinical trials are ongoing to see if it has a positive impact on the efficacy of some kidney cancer treatments, particularly immunotherapy, and improve clinical outcomes.
Researchers from City of Hope Comprehensive Cancer Center in Duarte, California, including Dr. Miguel Zugman who received a 2025 KCA Research Award for work on the impact of the gut microbiome on mRCC patients treated with the immunotherapies nivolumab and ipilimumab, sought to understand whether higher doses of CBM588 could be used and tolerated similarly.
CBM588 has not shown significant treatment-related adverse effects in prior studies. This trial included 12 mRCC patients who had not received treatment given CBM588 (via an oral capsule) at one of three doses in tandem with treatment with nivolumab and ipilimumab.
The primary endpoint was safety and the researchers reported “no dose-limiting toxicities were observed at any dose level, and no dose-dependent increase in immune-related toxicity was noted with CBM588 escalation.”
Nine out of the 12 patients experienced grade 3 or higher adverse events including acute kidney injury, and increased liver enzymes.
Secondary endpoints were response rate to immunotherapy treatment and progression-free survival. The researchers reported 4 patients objective responses, one of which was complete, 7 patients whose disease remained stable, and one whose disease progressed.
“CBM588 was well tolerated at the highest dose level in combination with nivolumab/ipilimumab,” the researchers said, noting that additional correlative studies are planned in a larger group of patients to further examine dose-associated differences in gut microbiome composition.
The researchers also said the findings support the selected dosing strategy for the planned phase III SWOG S2419 study (BioFront), the first trial of it’s kind to test gut microbiome intervention with CBM588 as part of standard-of-care kidney cancer immunotherapy regimens, which is set to activate April 1, 2026. [2026 ASCO GU, Abstract 503]
How kidney cancer patients manage emotional wellbeing
A global survey of kidney cancer patients showed that most confirmed their diagnosis impacted them emotionally but many did not make use of resources like support groups to manage their well being nor did many discuss their concerns with their care providers.
The Global Patient Survey, conducted by the International Kidney Cancer Coalition (IKCC), collected over 2,600 responses from 46 countries including Canada, the US, and Mexico. Among respondents, clear cell RCC was the most common diagnosis (62%), 54% were male, 80% were aged 46-80, and 19% were diagnosed at stage 4.
Globally, 85% of patient respondents (2,049 people) reported emotional impact from a kidney cancer diagnosis. The leading concerns were disease-related anxiety, fear of recurrence, sadness or depression, and fear of dying. Of least concern was problems obtaining health or life insurance.
In the US specifically, the leading concerns were similar but differently ordered with fear of recurrence ranking first followed by disease-related anxiety, sadness or depression, and general anxiety. Insurance problems were of least concern.
When patients did discuss their concerns with their care providers or make use of resources like support groups, they reported varying degrees of helpfulness. In the US, online support groups, patient organizations, and online education events were considered the most helpful resources and respondents wanted more access to online support groups, peer-to-peer support, and online education events.
The researchers encouraged more communication between providers and patients to talk about emotional concerns of a kidney cancer diagnosis, including referrals to patient support organizations that can address gaps in support resources.
The Kidney Cancer Association is an affiliate partner organization of the IKCC.
Is there any help for me, I have multiple Myloma, and on lamitamide, and Dara once a month. By the I have tumors in both kidneys.
Thanks in advance for your reply
Vince