SABR Combined With Axitinib and Toripalimab for Oligometastatic Renal Cell Carcinoma

NCT07744932 | Recruiting Phase 2

• 1 other identifier: 2026KY221-01
• Study Type: interventional
• Target: 48
• Locations: 1 country
• Sites: 1

Brief Summary

This is a phase II clinical trial testing whether a combination of stereotactic ablative radiotherapy (SABR), axitinib, and toripalimab is effective and safe for treating oligometastatic clear cell renal cell carcinoma (a type of kidney cancer that has spread to 5 or fewer sites). In this study, all metastatic tumors will be treated with SABR - a precise, high-dose radiation therapy delivered in 5 sessions. At the same time, participants will receive axitinib (an oral targeted cancer drug) twice daily, and toripalimab (an intravenous immunotherapy) every 3 weeks for up to 2 years. The study will enroll 48 participants. The main goal is to measure the objective response rate - the proportion of patients whose tumors shrink or disappear after treatment. Researchers will also track how long patients live without their cancer worsening, overall survival, and any side effects from the treatment. Participants will have regular imaging scans, blood tests, and quality-of-life assessments throughout the treatment and follow-up period.

Conditions

Oligometastatic Clear Cell Renal Cell Carcinoma

Outcome Measures

Primary Outcomes (1)

• Objective Response Rate (ORR)

  From enrollment to the end of treatment (up to approximately 2 years)

Secondary Outcomes (5)

• Local Control Rate

  From enrollment to the end of treatment (up to approximately 2 years)

• Disease Control Rate (DCR)

  From enrollment to the end of treatment (up to approximately 2 years)

• Progression-Free Survival (PFS)

  From first SABR to disease progression or death, whichever occurs first (up to approximately 4 years)

• Overall Survival (OS)

  From first SABR to death from any cause (up to approximately 4 years)

• Safety (Adverse Events)

  From first dose of study treatment to 30 days after last dose (up to approximately 2.5 years)

Study Arms (1)

SABR + Axitinib + Toripalimab

EXPERIMENTAL

All participants receive stereotactic ablative radiotherapy (SABR) to all measurable metastatic lesions (≥7 Gy per fraction, 5 fractions, BED₃ ≥ 115 Gy), concurrent axitinib (5 mg orally twice daily) and toripalimab (240 mg intravenously every 3 weeks for up to 35 cycles). Axitinib is continued until disease progression, intolerable toxicity, or withdrawal of consent. For oligoprogressive lesions (≤5 lesions), additional SABR may be administered at the investigator's discretion.

Drug: axitinib plus toripalimab; Radiation: SABR

Interventions

axitinib plus toripalimab DRUG

Axitinib 5 mg administered orally twice daily continuously, combined with toripalimab 240 mg administered intravenously every 3 weeks for up to 35 cycles (approximately 2 years).

SABR + Axitinib + Toripalimab

SABR RADIATION

All participants receive stereotactic ablative radiotherapy (SABR) to all measurable metastatic lesions, delivering ≥7 Gy per fraction in 5 fractions, achieving a biologically equivalent dose (BED₃) ≥ 115 Gy based on α/β = 3 Gy. For lesions adjacent to organs at risk, partial-SABR is permitted. If SABR or partial-SABR is infeasible, moderately hypofractionated radiotherapy (MHFRT) with curative intent may be substituted at the discretion of the radiation oncologist.

SABR + Axitinib + Toripalimab

Eligibility Criteria

• Age: 18 Years+
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• Histologically confirmed diagnosis of clear cell renal cell carcinoma (ccRCC).
• Age ≥ 18 years.
• Eastern Cooperative Oncology Group (ECOG) performance status of 0-2.
• Radiological evidence of distant metastasis meeting the MD Anderson (MDA) definition of oligometastatic disease: ≤5 metastatic lesions, all amenable to curative-intent local therapy. Lesions must be measurable per RECIST 1.1 criteria.
• Prior definitive local therapy to the primary tumor, including surgery, stereotactic radiotherapy, or ablation.
• Either no prior systemic therapy for metastatic disease (first-line naïve), or prior first-line tyrosine kinase inhibitor (TKI) therapy only with subsequent oligoprogression (≤5 progressive lesions with remaining lesions stable).
• Adequate organ function:
• Hemoglobin (Hb) ≥ 80 g/L
• Absolute neutrophil count (ANC) ≥ 1.5 × 10⁹/L
• Platelet count (PLT) ≥ 75 × 10⁹/L
• Serum total bilirubin ≤ 1.5 × upper limit of normal (ULN)
• Alanine aminotransferase (ALT) and aspartate aminotransferase (AST) ≤ 3 × ULN
• Prothrombin time (PT) and activated partial thromboplastin time (aPTT) ≤ 1.5 × ULN
• Voluntary written informed consent obtained, with commitment to complete all treatment and follow-up visits.

You may not qualify if:

• Target lesions previously treated with radiotherapy with a biologically effective dose (BED₃) ≥ 60 Gy (calculated with α/β = 3 Gy).
• Target lesions deemed unsuitable for radiotherapy by the treating radiation oncologist (e.g., lesions invading the gastrointestinal tract or penetrating the bronchus).
• Uncontrolled malignant pleural effusion or ascites.
• Presence of other uncured malignancies.
• History of severe psychiatric illness interfering with understanding of informed consent or compliance with study procedures.
• Severe cardiovascular disease: New York Heart Association (NYHA) class III-IV heart failure, uncontrolled arrhythmia, or myocardial infarction within the past 6 months.
• Any other serious medical condition that, in the investigator's judgment, may pose significant risk or interfere with radiotherapy.
• Pregnancy, breastfeeding, or planned pregnancy during the study period.
• Any other reason determined by the investigator that makes the participant unsuitable for study participation.

Sponsors & Collaborators

• Hebei Medical University Fourth Hospital: lead

Study Sites (1)

the Fourth Hospital of Hebei Medical University

Shijiazhuang, Hebei, 050011, China

RECRUITING

MeSH Terms

Interventions

Axitinib; toripalimab

Intervention Hierarchy (Ancestors)

Benzamides; Amides; Organic Chemicals; Benzoates; Acids, Carbocyclic; Carboxylic Acids; Benzene Derivatives; Hydrocarbons, Aromatic; Hydrocarbons, Cyclic; Hydrocarbons; Indazoles; Pyrazoles; Azoles; Heterocyclic Compounds, 1-Ring; Heterocyclic Compounds; Heterocyclic Compounds, 2-Ring; Heterocyclic Compounds, Fused-Ring

Central Study Contacts

Linlin Xiao, Dr

CONTACT

18533167355; drxiaolinlin@163.com

Fengpeng Wu

CONTACT

15032818011; wfpzhj@126.com

Study Design

• Study Type: interventional
• Phase: phase 2
• Allocation: NA
• Masking: NONE
• Purpose: TREATMENT
• Intervention Model: SINGLE GROUP
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Study Record Dates

• First Submitted: July 30, 2026
• First Posted: August 4, 2026
• Study Start (Estimated): August 15, 2026
• Primary Completion (Estimated): December 30, 2027
• Study Completion (Estimated): December 30, 2029
• Last Updated: August 4, 2026

Record last verified: 2026-07

Locations

CN (1)