Hello, I’m Natalia Gandur, I’m from Argentina, and I’d like to share with you the most relevant highlights in renal cell carcinoma presented at ESMO 2025.
This year’s meeting brought remarkable progress, particularly in the use of immunotherapy in early stage and in personalised treatment strategies. The most anticipated trial was RAMPART, presented by James Larkin during the Presidential Symposium. This study evaluated durvalumab alone or combined with tremelimumab as adjuvant therapy in this scenario: after a nephrectomy in patients with high risk of recurrence. The results were clear – disease free survival improved significantly with about a 35% risk reduction, especially in high risk patients. Importantly, the safety profile was manageable and quality of life remained stable. RAMPART marks a turning point, the first adjuvant immunotherapy combination showing benefit in renal cell carcinoma.
Another very interesting study was NESCIO, presented by Dr Bergers. This trial explored a neoadjuvant immunotherapy, meaning treatment before surgery. Patients received just two doses of nivolumab alone or combined with ipilimumab or relatlimab. Relatlimab is LAG-3 inhibitor that helps reactivate exhausted T-cells. High pathological response rates were achieved without surgical delays; this opened the door to short, effective and safe pre-surgical immunotherapy approaches.
The second study was OPTIC-RCC trial presented by Dr Scott Haake. A pioneering study assessing treatment based on tumour RNA sequencing. Patients with angiogenic gene signatures received cabozantinib plus nivolumab, reaching an impressive 76% objective response rate and no primary progressions. This represented a major step forward, real [??] precision oncology in kidney cancer.
Finally, the SUNNIFORECAST study, led by Lothar Bergmann and Marit Ahrens, demonstrated that ipilimumab plus nivolumab improved survival to 45 months versus 10 months in non-clear renal cell carcinoma with PD-L1 positivity, extending the benefit of immunotherapy to various subtypes.
In summary, ESMO 2025 consolidated the role of immunotherapy across all stages of renal cancer: adjuvant therapy from RAMPART, neoadjuvant therapy with NESCIO, biology driven precision therapy with OPTIC and expanded benefit in rare subtypes with SUNNIFORECAST. From Berlin, I’m Natalia Gandur and these were the key updates in renal cancer from ESMO 2025 for ecancer. Thank you so much.
