194 RCC Clinical Trials Recruiting Now (July 2026): Renal Cell Carcinoma — IO+TKI, HIF-2α, Belzutifan, Casdatifan, Zanzalintinib, CAR-T
Last updated: July 1, 2026
Current Clinical Trial Landscape
Active research areas in 2026:
- Immunotherapy combinations: IO+TKI (pembrolizumab + lenvatinib/axitinib, nivolumab + cabozantinib), IO+IO (nivolumab + ipilimumab), and triplet regimens stratified by IMDC risk
- HIF-2α inhibitors and next-gen TKI combinations: belzutifan + zanzalintinib (LITESPARK-034, NCT07489495 and NCT07227402); casdatifan + cabozantinib (NCT07011719) — the central Phase 3 storyline of advanced ccRCC in 2026
- TKI-based regimens: cabozantinib, lenvatinib, axitinib, tivozanib, zanzalintinib, vorolanib combinations across lines of therapy
- Adjuvant programs: post-nephrectomy tivozanib + pembrolizumab (NCT06661720), MRD-guided adjuvant therapy (NCT06005818), RAMPART multi-arm trial (NCT03288532) — building on the KEYNOTE-564 adjuvant pembrolizumab standard
- Novel modalities: CAIX-targeted radiopharmaceuticals (177Lu-TLX250), CD70 CAR-T, allogeneic NK cells (EBNK-001), neoantigen vaccines, live biotherapy (MO-03)
Already approved: Nivolumab + cabozantinib, pembrolizumab + lenvatinib (Lenvima, CLEAR Phase 3), nivolumab + ipilimumab, axitinib + pembrolizumab (1L advanced); pembrolizumab adjuvant (KEYNOTE-564, intermediate-high/high risk after nephrectomy); belzutifan (VHL-associated tumors, and advanced ccRCC post anti-PD-1 and VEGF-TKI). Lenvima + everolimus is also FDA-approved 2L RCC after prior VEGF-targeted therapy (Study 205 Phase 2).
Post-ASCO 2026 update (June 13): The HIF-2α + next-generation TKI combination is the dominant Phase 3 storyline in advanced clear-cell RCC. Belzutifan + zanzalintinib has two recruiting Phase 3 trials:
LITESPARK-034 (NCT07489495) in RCC broadly, and
NCT07227402 in patients recurring after adjuvant therapy. Casdatifan + cabozantinib (
NCT07011719) provides a competing HIF-2α / TKI Phase 3 comparator. Patients should ask whether they meet HIF-2α combination eligibility — particularly in the post-IO+TKI second-line setting where standard options remain limited.
Recruiting Trials by Treatment Stage
First-Line (Treatment-Naive Advanced/Metastatic)
IO+TKI and IO+IO combinations are standard first-line. Trials explore HIF-2α addition, novel triplets, IO de-escalation, and adjunctive biotherapy:
- HIF-2α + TKI Phase 3 (new in 2026):
- NCT07489495 - LITESPARK-034: Belzutifan + Zanzalintinib in RCC (Phase 3)
- NCT07011719 - Casdatifan + Cabozantinib vs Placebo + Cabozantinib in advanced ccRCC (Phase 3)
- NCT07239596 - SHR-8068 + Adebrelimab + anti-tumor drugs in advanced RCC (Phase 1b/2)
- IO de-escalation:
- NCT05078047 - IO every 3 months vs standard dosing in responding patients (Phase 3)
- NCT07175480 - PET/CT-directed treatment-free intervals for IMDC favorable/intermediate risk (Phase 2)
- Adjunctive / microbiome modulation:
- NCT07383441 - MO-03 live biotherapy added to standard IO (ipi/nivo, axi/pembro, cabo/nivo, lenva/pembro) in advanced ccRCC (Phase 3)
After IO Progression (Second-Line+)
A major unmet need — what to do after IO+TKI failure:
- HIF-2 inhibitor combinations:
- NCT07227402 - Belzutifan + Zanzalintinib (next-gen TKI) for recurrent RCC after adjuvant therapy (Phase 3)
- NCT07405164 - Belzutifan LITESPARK-043 extension study for participants continuing from MK-6482-043 (Phase 3, activated 2026-06 — enables long-term follow-up + rollover access for prior belzutifan trial patients including VHL-associated ccRCC)
- NCT06234605 - HC-7366 + Belzutifan in RCC (Phase 1/2)
- NCT07049926 - KEYMAKER-U03: Combination therapies for RCC recurrent after anti-PD-(L)1 (Phase 2)
- Novel combinations:
- NCT06730672 - Voronib + Everolimus after IO failure (Phase 2)
- NCT07469683 - SLC-3010 + Axitinib vs Axitinib monotherapy second-line ccRCC (Phase 2)
- NCT03592472 - RENAVIV: Pazopanib ± Abexinostat (HDACi) in advanced RCC (Phase 3)
- Radiopharmaceuticals:
- NCT07197580 - 177Lu-TLX250 (CAIX-targeted) in advanced relapsed/recurrent ccRCC (Phase 3)
Neoadjuvant / Perioperative
- NCT05738694 - Neoadjuvant Axitinib + PD-1 to improve DFS (Phase 3)
- NCT05969496 - Neoadjuvant Pembrolizumab + Axitinib for IVC tumor thrombus (Phase 2)
- NCT05319015 - Neoadjuvant Lenvatinib + Pembrolizumab for IVC tumor thrombus (Phase 2)
- NCT07386158 - Pucotenlimab + Vorolanib neoadjuvant for ccRCC (Phase 2)
- NCT07187778 - BLAZE: Belzutifan or Pembrolizumab vs combination neoadjuvant in ccRCC (Phase 2)
Adjuvant (After Surgery)
- NCT03288532 - RAMPART: Multi-arm adjuvant trial (Phase 3)
- NCT06661720 - Tivozanib + Pembrolizumab after surgery to remove all known sites (Phase 3)
- NCT06005818 - MRD-guided adjuvant therapy (Phase 2)
Oligometastatic / Radiation Approaches
- NCT06467097 - Systemic therapy ± radiotherapy in oligometastatic RCC (Phase 3)
- NCT06726421 - STROKER: Systemic therapy ± SBRT for oligometastatic kidney cancer (Phase 3)
- NCT06255223 - Multimodal radiotherapy for RCC progressed after IO (Phase 2)
Novel Approaches
- CAR-T / cellular therapy: NCT02830724 - CD70-targeting CAR-T for CD70-expressing cancers including RCC; NK cell therapies (NCT07410676 - EBNK-001 allogeneic NK cells)
- Radiopharmaceuticals: 177Lu-TLX250 targeting CAIX (carbonic anhydrase IX), highly expressed in ccRCC
- Neoantigen vaccines: NCT05269381 - Personalized neoantigen peptide vaccine + Pembrolizumab
- Cytoreductive surgery + IO: NCT04510597 - PROBE: IO+TKI ± nephrectomy in metastatic RCC (Phase 3)
Frequently Asked Questions
How do I find kidney cancer clinical trials?
Paste your medical summary into ClinTrialFinder to get AI-matched renal cell carcinoma trials in minutes. The tool considers your histology (clear cell, papillary, chromophobe, sarcomatoid features), IMDC risk group, prior therapies (IO, TKI, belzutifan), and VHL status to find the most relevant trials.
What renal cell carcinoma trials are currently recruiting?
There are 194 recruiting interventional trials for RCC in July 2026, of which 17 are Phase 3. They include immunotherapy combinations (IO+TKI, IO+IO, triplets), TKI-based regimens (cabozantinib, lenvatinib, axitinib, tivozanib, zanzalintinib), HIF-2α inhibitors (belzutifan, casdatifan), CAR-T cell therapy (CD70-targeted), radiopharmaceuticals (177Lu-TLX250), and adjuvant programs following the KEYNOTE-564 pembrolizumab adjuvant standard.
What are the new Phase 3 belzutifan combinations in RCC in 2026?
Belzutifan (the first-in-class HIF-2α inhibitor, FDA-approved for advanced RCC in 2023) now has two parallel Phase 3 programs in combination with zanzalintinib, a next-generation VEGFR/MET/AXL TKI: LITESPARK-034 (NCT07489495) in RCC, and a recurrent-after-adjuvant trial (NCT07227402). Casdatifan (a competing HIF-2α inhibitor) is in Phase 3 combined with cabozantinib (NCT07011719). The HIF-2α + next-gen TKI combination is the major Phase 3 storyline in advanced ccRCC for 2026.
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