A combination of two immunotherapy drugs benefits people with kidney cancer
21 Oct 2025
Results from the RAMPART trial show that, for people with kidney cancer, a combination of two immunotherapy drugs helps prevent the cancer from coming back after surgery. These findings were presented last weekend at the European Society for Medical Oncology (ESMO) congress in Berlin, Germany.
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 monitor patients closely to check for signs of cancer returning.
To find a better approach, RAMPART aimed to answer two questions. The first was whether a combination of two immunotherapy drugs (durvalumab and tremelimumab) could reduce the chance of kidney cancer coming back. The second question was whether just one immunotherapy drug (durvalumab) could do the same.
Both drugs, durvalumab and tremelimumab, are types of immunotherapies that help the immune system find and destroy cancer cells.
In the trial, 790 people were randomly assigned to one of three groups:
- Group A: 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)
After three years of follow-up, 81% of people receiving durvalumab and tremelimumab remained cancer-free, compared to 73% of people who did not receive any treatment but were monitored for signs of their cancer returning.
When looking at people who were at higher risk of their cancer coming back, the benefit was even greater. In this subgroup, 78% of people receiving durvalumab and tremelimumab remained cancer-free after three years, versus 61% of people who did not receive any treatment but were monitored for signs of their cancer returning. The risk of cancer coming back was assessed by doctors after surgery based on several factors, including the stage of the cancer when it was diagnosed, if the cancer had spread to nearby lymph nodes, and the size of the cancer.
The side effects experienced by people who received durvalumab and tremelimumab were consistent with those previously reported for these drugs.
The trial is still ongoing. The team expects to share results comparing durvalumab alone with monitoring in 2026. Results looking at survival across all three groups will be available in the coming years.
The RAMPART trial took place in 80 hospitals in the UK, Australia, France, and Spain. It was sponsored by UCL and led by the MRC Clinical Trials Unit at UCL. The research was conducted with support from AstraZeneca UK Limited.
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