eligibility_summary
Include: RCC, unresectable node+ or metastatic (IMDC intermediate/poor), measurable extra‑renal disease, no immediate CN, eligible for IO combo, primary ≤20 cm, age ≥18, KPS ≥60, adequate organ function, consent/contraception. Exclude: plan to definitively treat all mets, untreated/unstable brain mets, prior overlapping kidney RT or RCC therapy >90 d earlier, major comorbidity (autoimmune on steroids, significant cardiac/vascular/hepatic/infectious/GI or recent surgical issues), pregnancy/nursing.
trial_source
clinical_trials.gov from Dec 2, 2025
annotation_status
ai
ai_summary
NCT05327686 (SAMURAI): Randomized phase II testing stereotactic ablative radiotherapy (SABR) added to standard immunotherapy in unresectable/metastatic RCC. Interventions and mechanisms: • SABR (high-dose, focal radiation) induces tumor cell death, antigen release, and potential abscopal immune effects. • Immune checkpoint inhibitors (monoclonal antibodies): nivolumab, pembrolizumab (anti‑PD‑1), avelumab (anti‑PD‑L1), ipilimumab (anti‑CTLA‑4) to reactivate T cells. • Antiangiogenic tyrosine kinase inhibitors (TKIs): axitinib (VEGFR), cabozantinib (VEGFR2/MET/AXL), lenvatinib (VEGFR1‑3/FGFR/PDGFRα/RET/KIT) to inhibit tumor vasculature and oncogenic signaling. Targets/pathways: T‑cell checkpoints (PD‑1/PD‑L1, CTLA‑4) on T cells and tumor/immune cells, VEGF/VEGFR-driven angiogenesis, MET/AXL/FGFR pathways in tumor and microenvironment. Goal: improve nephrectomy and radiographic PFS vs immunotherapy alone.