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Not yet recruitingNCT07922928TL-SBRT-nccRCCUpdated Nov 6, 2026

Toripalimab and Lenvatinib With or Without SBRT Before Surgery for Non-Clear Cell Kidney Cancer

A Phase 2 interventional study of Toripalimab and Lenvatinib in Nonmetastatic Locally Advanced Non-Clear Cell Renal Cell Carcinoma, sponsored by Sun Yat-sen University. Not yet recruiting. Open to participants aged 18 Years and older. Per ClinicalTrials.gov, last updated 2026-11-06.

Sponsored by Sun Yat-sen University · Phase 2, Interventional, and Treatment

Updated Nov 6, 2026Newly registeredGo to Updates ↓
Phase
Phase 2
Study type
Interventional
Enrollment
36
Allocation
Non-randomized
Ages
18 Years and older
Sex
All
01

Study summary

This single-center, nonrandomized, two-cohort Phase II study will evaluate neoadjuvant toripalimab and lenvatinib with or without stereotactic body radiotherapy (SBRT) in patients with resectable, nonmetastatic locally advanced non-clear cell renal cell carcinoma. Approximately 36 participants will be enrolled. Both cohorts will receive six 21-day cycles of toripalimab and lenvatinib; one cohort will also receive SBRT to the primary renal tumor. Surgery is planned after neoadjuvant treatment. The primary outcome is the percentage of necrotic tumor cells in the resected tumor specimen.

Read the detailed description

Eligible participants with histologically confirmed, resectable, nonmetastatic locally advanced non-clear cell renal cell carcinoma will be enrolled into two nonrandomized cohorts. Cohort A will receive toripalimab 240 mg intravenously on day 1 of each 21-day cycle plus lenvatinib 12 mg orally once daily for six cycles. Cohort B will receive the same systemic treatment plus SBRT to the primary renal tumor at a total dose of 40 Gy in five fractions, delivered after completion of cycle 2 and before cycle 4. Tumor response will be assessed by imaging during and at the end of neoadjuvant treatment. Surgery will follow neoadjuvant treatment; the operating physician will determine the surgical approach based on imaging. Resected tumor specimens will be assessed for tumor cell necrosis and pathological response. Participants will be followed for recurrence, survival, and adverse events.

02

Conditions studied

  • Nonmetastatic Locally Advanced Non-Clear Cell Renal Cell Carcinoma

Keywords

  • Non-clear cell renal cell carcinoma; Neoadjuvant therapy; Toripalimab; Lenvatinib; Stereotactic body radiotherapy; Nephrectomy
03

In context

Carcinoma, Renal Cell

2,037 studies on the registry are indexed under Carcinoma, Renal Cell; 395 are open to participants now.

This study's planned enrollment of 36 is below the median of 43 across 1,564 interventional studies indexed under Carcinoma, Renal Cell.

Browse Carcinoma, Renal Cell studies →

Lead sponsor

Sun Yat-sen University is the lead sponsor of 1,690 studies on the registry; 619 are open to participants now.

Counted across the registry records on this site, refreshed daily.

04

Who can participate

Ages eligible
18 Years and older
Sexes eligible
All
Accepts healthy volunteers
No

Go through the criteria one by one — yes, no or not sure — and take the list to your doctor or the study team. Kept in this browser only.

Inclusion criteria

  • Voluntary written .
  • Age 18 years or older.
  • performance status of 0 or 1 and of at least 6 months.
  • confirmed, resectable, nonmetastatic locally advanced non-clear cell renal cell carcinoma, excluding chromophobe and collecting duct carcinoma. Eligible disease includes T3aNxM0, T3bNxM0 without level III or IV venous tumor thrombus, T4NxM0, or TxN1M0.
  • At least one according to version 1.1.
  • Adequate organ function: ≥80 g/L; ≥1.5 × 10\^9/L; white blood cell count ≥3.5 × 10\^9/L; ≥80 × 10\^9/L; and AST ≤2.5 × (ULN); total ≤1.5 × ULN; serum creatinine ≤1.5 × ULN or ≥60 mL/min; , INR, and PT ≤1.5 × ULN.
  • Women of must be confirmed not pregnant before enrollment. All participants must use adequate during treatment and for 4 weeks after treatment completion.
  • Willingness and ability to comply with study procedures.

Exclusion criteria

Exclusion Criteria:

  • Known to toripalimab, lenvatinib, or their .
  • Chromophobe or collecting duct renal cell carcinoma.
  • Anticancer monoclonal antibody or another drug within 4 weeks before enrollment; prior /PD-L1-directed treatment for disease; or prior lenvatinib or another antiangiogenic drug.
  • Distant organ metastasis or inability to undergo surgery.
  • Systemic treatment, including prednisone >10 mg/day or equivalent, within 2 weeks before enrollment.
  • Active disease, a history of autoimmune disease, or congenital or acquired immunodeficiency.
  • Poorly controlled cardiac disease, uncontrolled hypertension, or cardiovascular events within 6 months before enrollment.
  • Chemotherapy, targeted therapy, or radiotherapy within 2 weeks before enrollment.
  • Gastrointestinal perforation or major surgery within 4 weeks before enrollment.
  • Arterial or venous thromboembolic event within 6 months before enrollment, except resolved catheter-associated thrombosis as judged by the investigator.
  • Active bleeding or a significant bleeding tendency, including clinically significant hemoptysis of more than 50 mL/day within 3 months before enrollment.
  • Urine dipstick protein ≥2+ or 24-hour urine protein ≥1.0 g.
  • interval >470 ms, subject to the protocol-specified review for pacemaker-related QT prolongation.
  • Suspected additional primary .
  • Interstitial lung disease, noninfectious pneumonitis, or another uncontrolled systemic disease.
  • within 28 days before first treatment or planned live attenuated vaccination during the study.
  • Active (HBV DNA ≥500 IU/mL), active (HCV RNA above the assay detection limit), or hepatitis B and C coinfection.
  • Severe infection within 4 weeks before first treatment; grade ≥2 active infection requiring systemic antibiotics within 2 weeks before first treatment; unexplained fever >38.5°C during screening or before first treatment unless attributed to the tumor by the investigator; or evidence of active tuberculosis within the preceding year.
  • Prior or planned allogeneic bone marrow or solid-organ transplantation.
  • Peripheral neuropathy of grade ≥2, active , , or spinal cord compression.
  • Inability to swallow oral medication, chronic diarrhea, clinically significant intestinal obstruction, or another condition substantially affecting oral-drug absorption.
  • Pregnancy, breastfeeding, or plans to become pregnant during the study.
  • Any other serious physical or psychiatric illness or laboratory abnormality that may increase study risk, interfere with results, or make participation inappropriate in the investigator's judgment.
Terms in these criteria, in plain language(32)

Underlined terms in the criteria open these too. Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.

Informed consent

Before you join, the study team explains what taking part involves — its purpose, what happens, the risks and possible benefits — and answers your questions, so you can decide freely. Consent is usually recorded on a form (the informed consent form, ICF) signed by you or, where the law allows, by someone legally authorised to decide for you.

You can keep asking questions during the study, you are told of new information that matters, and you can choose to leave at any time.

ECOG performance status

A scale of how much an illness limits everyday activity. For people being assessed to join a study, scores run from 0 (fully active) to 4; lower is more active.

0
Fully active, no restrictions.
1
Limited in strenuous activity, but walking and able to do light work, such as housework or office work.
2
Walking and able to look after yourself, but unable to work; up and about more than half of waking hours.
3
Able to look after yourself only in part; in bed or a chair more than half of waking hours.
4
Unable to look after yourself at all; in bed or a chair all day.

Studies most often ask for 0–1 or 0–2. Your doctor gives the score; the WHO scale uses the same steps. The full scale also has 5, which records death.

Life expectancy

The study doctor’s estimate of how long someone is likely to live. Criteria use it so that people can stay in the study long enough for it to answer its question.

Histologically or cytologically confirmed

The diagnosis was confirmed by looking at a sample under a microscope: tissue from a biopsy or surgery (histology), or cells from a fluid or needle sample (cytology).

Your pathology report is the document that shows this.

Measurable disease

The amount of disease can be tracked with a defined measurement, so the study can see whether it shrinks or grows. It might be a tumour measured on a scan or, in some blood cancers such as myeloma, a marker measured in blood or urine.

The criteria or the study team say which measurement counts — having no tumour visible on a scan does not by itself rule you out.

RECIST

The standard rules for measuring tumours on CT or MRI scans, to tell whether a cancer is shrinking, stable or growing during treatment.

“Measurable disease per RECIST 1.1” usually means at least one tumour 10 mm or more at its longest on a CT scan, or a lymph node 15 mm or more across its short axis.

Hemoglobin (Hb)

The protein in red blood cells that carries oxygen. A low level is anaemia, which can cause tiredness and breathlessness. Measured in g/dL or g/L (9 g/dL is 90 g/L).

Absolute neutrophil count (ANC)

The number of neutrophils, white blood cells that help fight infection, in a given amount of blood. Too few raises the risk of infection.

It is a count, not a percentage of the white cells. Limits are written in units that mean the same: ≥ 1.5 × 10⁹/L is ≥ 1,500 per mm³ (µL). Each lab has its own reference range.

Platelets

Blood cells that help blood clot. Too few raises the risk of bleeding and bruising. A usual adult range is about 150–400 × 10⁹/L (150,000–400,000 per µL); each lab has its own reference range.

ALT and AST (liver enzymes)

Two enzymes measured in a routine blood test of the liver. Higher levels can mean the liver is under strain or damaged. SGPT and SGOT are older names for ALT and AST.

Criteria usually give a limit as a multiple of the upper limit of normal (ULN), often higher when cancer has spread to the liver.

ULN (upper limit of normal)

The top of the normal range for a blood test, as set by the laboratory that runs it. Each lab prints its own range next to your result.

“≤ 2.5 × ULN” means the result can be up to two and a half times that top value.

Bilirubin

A yellow substance made when red blood cells are broken down, which the liver clears. A high level can mean a problem with the liver or the bile ducts.

Criteria often allow more for people with Gilbert’s syndrome, a harmless inherited condition that raises bilirubin.

Creatinine clearance (CrCl)

How quickly the kidneys clear creatinine, a waste product, from the blood. A study may estimate it from a blood test with age, weight and sex (often by the Cockcroft–Gault formula), or measure it using blood and urine collected over a set time. Given in mL/min; higher is better.

INR, PT and aPTT (clotting tests)

Blood tests of how long blood takes to clot. The INR is the prothrombin time (PT) put on a common scale; about 1 is usual for someone not taking a blood thinner.

Criteria often make an exception for people on a blood thinner such as warfarin, whose INR is raised on purpose.

Childbearing potential

Able to become pregnant: from the first period until menopause, unless permanently unable to through surgery (removal of the womb, or of both ovaries or both fallopian tubes).

Criteria for people of childbearing potential usually ask for a negative pregnancy test and for contraception during the study and for a time after it.

Contraception

Ways of preventing pregnancy. “Highly effective” methods fail less than 1% of the time a year when used correctly — for example an IUD or an implant.

Criteria usually say which methods count and how long to keep using them after the last dose, sometimes for male participants too. Some studies accept a partner’s vasectomy if it was confirmed successful and that person is the participant’s only sexual partner.

Hypersensitivity

An allergy, or another reaction of the immune system, to a substance. “Hypersensitivity to the study drug” means a known allergic reaction to it — not every side effect a medicine can have.

Excipients

The other ingredients in a medicine besides the active drug, such as fillers, colours or preservatives.

Investigational drug or device

A drug or device being studied in a clinical trial.

It may be new, or already approved and being studied for another use, dose or form. Criteria often leave out people who took part in another study of one within a recent period, commonly 30 days or five half-lives.

PD-1, PD-L1 and checkpoint inhibitors

PD-1, PD-L1 and CTLA-4 are proteins that act as brakes on the immune system. Checkpoint inhibitors, such as pembrolizumab or nivolumab, block them so the immune system can attack a cancer.

PD-L1 can also be measured in a tumour sample. Some scores count stained tumour cells only (TPS); others also count certain immune cells (CPS). The study names the score and the minimum it uses.

Metastases

Cancer that has spread from where it began to other parts of the body. “Metastatic” cancer is cancer that has spread this way.

Immunosuppression

A weakened immune system. It can come from an illness, such as HIV or some blood cancers, or from medicines that turn the immune system down, for example after an organ transplant or for an autoimmune disease; steroids at higher doses count.

Read whether the line is about a condition or about medicines, and which medicines and doses it means.

Autoimmune disease

A condition in which the immune system attacks the body’s own tissues, such as rheumatoid arthritis, lupus, psoriasis, type 1 diabetes or inflammatory bowel disease.

Immunotherapy studies often leave out active autoimmune disease, and some name exceptions, such as thyroid disease on replacement hormone. Check the exceptions this study lists.

Clinically significant

Judged by the study doctor to matter for your health or for the study. It is a doctor’s decision, so ask the study team if you are unsure whether something counts.

QT and QTc

On an ECG, the QT interval is the time the heart’s lower chambers take to activate electrically and recover in each beat. QTc is that time adjusted for heart rate (QTcF by Fridericia’s formula, QTcB by Bazett’s). Some medicines lengthen it, and a long QTc can raise the risk of a dangerous heart rhythm.

The study may name a correction formula and a limit in milliseconds, often around 450–480.

Cancer (malignancy)

Malignancy means cancer. Criteria about another or earlier malignancy ask whether you have had a different cancer, usually within a set number of years.

Some are commonly allowed, such as treated skin cancers other than melanoma and early cancers removed completely — check the exceptions this study lists.

Live vaccines

Vaccines made with a weakened form of the germ, such as measles–mumps–rubella (MMR), chickenpox and yellow fever. They can be risky when the immune system is weakened. Flu injections are not live; the nasal flu spray is.

Hepatitis B tests

Hepatitis B is a virus that infects the liver. These are separate tests: HBsAg positive usually means a current infection (a recent vaccination can briefly cause it too); total anti-HBc (HBcAb) positive means an infection now or in the past; HBV DNA measures how much virus is in the blood.

Some studies accept a past infection if HBV DNA is undetectable, sometimes with antiviral medicine during the study. Check what this study allows.

Hepatitis C tests

Hepatitis C is a virus that infects the liver. An HCV antibody test can stay positive after an infection has cleared (and is occasionally positive without one); an HCV RNA test shows whether the virus is there now.

After treatment, hepatitis C counts as cured when HCV RNA is still undetectable 12 weeks or more after the treatment ended. Studies often accept people cured this way.

CTCAE grade

The US National Cancer Institute’s scale of how severe an adverse event is — any unwanted medical event during a study, such as a symptom, an illness or an abnormal test result, whether or not a treatment caused it. Whether it did is judged separately.

1
Mild.
2
Moderate.
3
Severe.
4
Life-threatening.
5
Death due to the event.

“Side effects of earlier treatment resolved to grade 1 or less” means they have settled to mild or gone.

Brain metastases

Cancer deposits in the brain from a cancer that started elsewhere in the body (CNS metastases include the spinal cord).

Studies differ: some leave out any brain metastases, some accept ones treated and stable for some weeks. Check what this study allows.

Leptomeningeal disease

Cancer that has spread to the leptomeninges, the thin layers covering the brain and spinal cord, and the fluid between them. It is not the same as brain metastases.

Criteria often treat it separately, and many studies leave it out even where treated brain metastases are allowed.

05

Study design

Phase
Phase 2
Primary purpose
Treatment
Allocation
Non-randomized
Intervention model
Parallel assignment
Masking
None (open label)
Enrollment
36 participants (estimated)

Study arms

  • Active comparator
    Toripalimab Plus Lenvatinib

    Toripalimab 240 mg intravenously every 3 weeks plus lenvatinib 12 mg orally once daily for six 21-day cycles, followed by surgery.

    Drug: Toripalimab · Drug: Lenvatinib

  • Experimental
    Toripalimab Plus Lenvatinib and SBRT

    Toripalimab 240 mg intravenously every 3 weeks plus lenvatinib 12 mg orally once daily for six 21-day cycles. SBRT at 40 Gy in five fractions is delivered to the primary renal tumor after cycle 2 and before cycle 4, followed by surgery.

    Drug: Toripalimab · Drug: Lenvatinib · Radiation: Stereotactic Body Radiotherapy

Interventions

  • Toripalimab 240 mg by intravenous infusion on day 1 of each 21-day cycle for six cycles.

  • Lenvatinib 12 mg orally once daily during six 21-day cycles of neoadjuvant treatment.

  • RadiationStereotactic Body Radiotherapy

    SBRT to the primary renal tumor, 40 Gy in five fractions, after cycle 2 and before cycle 4.

06

What researchers measure

Primary outcomes

  1. Tumor Cell Necrosis Rate (TCNR)

    Percentage of necrotic tumor cells in the resected tumor specimen, calculated from prespecified multisite pathological sampling.

    Time frame: At surgery following neoadjuvant treatment, approximately 5 to 6 months after the first dose.

Secondary outcomes

  1. R0 Resection Rate

    Percentage of enrolled participants who undergo complete tumor resection with microscopically negative margins.

    Time frame: At surgery following neoadjuvant treatment, approximately 5 to 6 months after the first dose.

  2. Objective Response Rate (ORR)

    Percentage of participants with investigator-assessed complete or partial response according to RECIST version 1.1.

    Time frame: From baseline through the final preoperative tumor assessment, approximately 18 weeks.

  3. Disease Control Rate (DCR)

    Percentage of evaluable participants with complete response, partial response, or stable disease according to RECIST version 1.1.

    Time frame: From baseline through the final preoperative tumor assessment, approximately 18 weeks.

  4. Major Pathological Response (MPR) Rate

    Percentage of resected participants with no more than 10% residual viable tumor in the tumor bed.

    Time frame: At surgery following neoadjuvant treatment, approximately 5 to 6 months after the first dose.

07

Study locations

No study locations are listed for this record.

08

References and documents

Individual participant data

Plan to share: No — Individual participant data will not be shared because this small study collects sensitive clinical, imaging, and molecular data that could increase the risk of participant re-identification. Study results will be reported in aggregate form.

No publications or documents are linked to this record.

09

Updates

1 registry update since Sep 25, 2026
Registered
First appeared on the registry. No changes since
Nov 6, 2026
Show all 1 update
  1. Nov 6, 2026
    First appeared on the registry

From the registry record's own update history. This site started tracking changes on Sep 25, 2026; for anything earlier, see the record history on ClinicalTrials.gov ↗

10

Registry details

Key details

Study ID
NCT07922928
Responsible party
ZHOU FANGJIAN (Prof, Sun Yat-sen University) — Principal investigator
First posted
Nov 6, 2026
Start date
Nov 10, 2026 (estimated)
Primary completion
Dec 31, 2029 (estimated)
Completion
Dec 31, 2030 (estimated)
Last update
Nov 6, 2026

Study contacts

Yulu Peng
Contact
pengyl1@sysucc.org.cn
02087342318

Oversight

Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

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