Combination Immunotherapy Dramatically Improves Kidney Cancer Survival Rates, Landmark Trial Shows
A new combination immunotherapy treatment has significantly improved disease-free survival following surgery for patients with renal cell carcinoma (RCC), the moast common type of kidney cancer, according to results unveiled at the European Society for Medical Oncology (ESMO) congress in July 2025. The findings, stemming from the Phase III RAMPART trial, offer renewed hope for individuals at high risk of cancer recurrence.
The RAMPART trial was designed to determine whether immunotherapy could prevent the return of disease in patients with early-stage kidney cancer who had undergone surgery. The trial,conducted by the Trials Unit at University College London (MRC CTU at UCL),involved 345 participants who were randomly assigned to one of three groups: active monitoring,durvalumab alone for one year,or durvalumab plus tremelimumab – with the combination administered during the initial two cycles. Data comparing durvalumab alone to active monitoring are anticipated in the future.
How the Treatment Works
Durvalumab and tremelimumab are immune checkpoint inhibitors, a form of targeted immunotherapy.These drugs function by enabling the immune system to locate and destroy cancer cells. By concurrently blocking two different checkpoints, the combination of durvalumab and tremelimumab can elicit a more robust immune response, increasing the number of cancer-fighting T cells and extending their activity at the tumor site. This ultimately leads to a stronger and more sustained anti-tumor immune response.
Notable Advancement in Disease-Free Survival
At the three-year mark,disease-free survival reached 81% in the group receiving the durvalumab and tremelimumab combination,compared to 73% in the active monitoring group,which involved regular observation without active treatment.The most substantial benefit was observed among patients identified as being at higher risk of relapse. In this subgroup, three-year disease-free survival was 78% with the combination treatment, versus 61% with active monitoring.
Patients were categorized as high-risk based on factors including the cancer’s stage at diagnosis,whether the cancer had spread to nearby lymph nodes,and the size of the primary tumor. Safety data were consistent with the established profiles of durvalumab, tremelimumab, and other immune checkpoint inhibitors.
“In a subgroup of patients facing a high risk of cancer returning after surgery, we saw a remarkable result, with over a 43 per cent relative reduction in the risk of recurrence,” stated a senior investigator involved in the study. “These are very promising findings that confirm the benefit of immunotherapy in the treatment of high-risk renal cell carcinoma.”
Another led researcher emphasized the importance of targeted treatment. “We are very pleased to see that this combination of immunotherapy drugs significantly reduces the risk of kidney cancer returning. Importantly, the greatest benefit was observed in participants who were at the highest risk of recurrence. As these treatments can cause serious side effects, it is indeed significant that we target their use to those most likely to benefit.”
Patient Perspective
The impact of the RAMPART trial extends beyond statistical data. Janet Middlehurst, a 69-year-old retired teacher from London diagnosed with Stage 3 kidney cancer in August 2019, shared her experience as a trial participant. “When I was diagnosed I didn’t even know if I’d see Christmas, so every day is a bonus, and I feel very lucky,” she said. “I’ve been in remission ever since joining the trial so it’s amazing to be on the other side. I’ve been able to spend time with my grandchildren and I’ll see my youngest son get married next year.”
Immunotherapy research at The Royal Marsden NHS Foundation Trust is supported by The Royal Marsden Cancer Charity, including funding for the West Wing Clinical Research Center. The RAMPART trial was sponsored by UCL and received financial support from AstraZeneca UK Limited.
The positive outcomes of the RAMPART trial represent a significant advancement in the treatment of kidney cancer, offering a new avenue for preventing recurrence and improving long-term survival for patients at highest risk.
