GU Cancers 2026 | BOOST-RCC: evolocumab and nivolumab in metastatic renal cell carcinoma
Tian Zhang, MD, UT Southwestern Medical Center, Dallas, TX, describes the Phase II BOOST-RCC trial (NCT06284564) of evolocumab and nivolumab in patients with metastatic clear cell renal cell carcinoma (mRCC) refractory to prior immune checkpoint inhibitors. By inhibiting pcsk9 to potentially enhance tumor antigen presentation and overcome resistance, the study assesses objective response rates and safety. Utilizing a 2-stage design, this investigator-initiated trial aims to determine if adding evolocumab improves outcomes in this difficult-to-treat population. This interview took place at the 2026 ASCO GU Cancers Symposium in San Francisco, CA.
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Transcript
This is an investigator-initiated trial. It’s a phase two, which is combining evolocumab and nivolumab for patients with metastatic clear cell kidney cancer who have gone through frontline immunotherapy doublet combinations. And we’re trying to improve tumor antigen expression by blocking PCSK9. Now, this class of inhibitors is well used now for hypercholesterolemia in their effect in recycling the LDL receptor...
This is an investigator-initiated trial. It’s a phase two, which is combining evolocumab and nivolumab for patients with metastatic clear cell kidney cancer who have gone through frontline immunotherapy doublet combinations. And we’re trying to improve tumor antigen expression by blocking PCSK9. Now, this class of inhibitors is well used now for hypercholesterolemia in their effect in recycling the LDL receptor. But in tumor immunity and tumor biology, PCSK9 inhibition can also recycle and upregulate MHC class 1 expression and therefore tumor antigen presentation. So using that hypothesis, we generated this particular phase 2 trial in kidney cancer, enrolling patients with refractory disease and treating with the combination. The trial is ongoing. We’re open, and we’ve actually finished the first stage of accruals for the first 10 patients at MD Anderson and UT Southwestern. It is a trial that’s coordinated through the DoD-supported Kidney Cancer Research Consortium. And so we’ll see. But I think there’s interesting interactions between the tumor antigen presentation effects of PCSK9 inhibition and hopefully can improve checkpoint inhibitor responses.
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