Using two immunotherapy drugs together benefits people with kidney cancer
02 Jun 2026
New results from the RAMPART trial show that, for people with kidney cancer, having one immunotherapy drug (durvalumab) does not help prevent kidney cancer from coming back compared to active monitoring. These findings were presented last weekend at the American Society of Clinical Oncology (ASCO) Annual Meeting in Chicago, US.
In the UK, kidney cancer is the sixth most common cancer, with around 4,700 deaths each year. The standard treatment is surgery to remove all or part of the kidney. When RAMPART started, there were no globally accepted treatments to reduce the risk of the cancer coming back after surgery. The standard of care was to closely monitor patients to check for signs of cancer returning.
To find a better approach, RAMPART aimed to assess whether immunotherapy could prevent recurrence of disease in patients with early-stage kidney cancer who have undergone surgery.
The study investigated whether treatment with durvalumab alone, or durvalumab in combination with tremelimumab, could reduce the chance of kidney cancer coming back after surgery, compared to active monitoring.
Both drugs, durvalumab and tremelimumab, are types of immunotherapies that help the immune system find and destroy cancer cells.
790 people took part in the trial. They were randomly assigned to one of three groups:
- Group A: active monitoring (standard care)
- Group B: durvalumab alone for one year
- Group C: durvalumab and tremelimumab (durvalumab for one year and tremelimumab given during the first two cycles of treatment only)
Results presented at ASCO compared people treated with durvalumab alone against those receiving active monitoring. After three years, 78% of people receiving durvalumab remained cancer-free, compared to 72% of people who were just monitored for signs of their cancer coming back, but the difference was not statistically significant. This means that giving durvalumab alone did not help prevent the cancer from coming back compared to active monitoring.
These findings build on previously reported results from the RAMPART trial, which showed that a combination of both immunotherapy drugs significantly improved disease-free survival in kidney cancer patients following surgery. In the group receiving two immunotherapy drugs, 80% of people remained cancer-free after three years. In this group, the risk of the cancer coming back, getting worse, or causing death was reduced by 35%.
The greatest benefit of using both immunotherapy drugs was observed among patients who were at a higher risk of their cancer coming back. In this subgroup, 76% of people receiving durvalumab and tremelimumab remained cancer-free after three years, compared with 61% of people who were monitored for signs of their cancer returning. In patients with the highest risk of the cancer coming back, getting worse, or causing death was reduced by 48% when compared to active monitoring. By targeting two different immune checkpoints, the drugs work together to stimulate an enhanced anti-tumour immune response.
Patients were classified as higher risk based on factors including the stage of the cancer when it was diagnosed, whether the cancer had spread to nearby lymph nodes, and the size of the primary tumour.
Safety findings, including the side effects and adverse events observed during the study, were consistent with the known safety profiles of durvalumab, tremelimumab and other immune checkpoint inhibitors. In addition, people’s quality of life was similar across all groups in the trial.
RAMPART was conducted across 80 sites in the UK, Australia, France, and Spain between October 2018 and June 2023. It was sponsored by UCL and led by the UCL Innovative Clinical Trials Unit. The study was conducted with financial support from AstraZeneca UK Limited and a grant from Kidney Cancer UK.
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