Background:
After surgery, some patients still have a risk that their cancer could come back. This study uses a blood test that looks for small pieces of tumor DNA that can circulate in the bloodstream, called circulating tumor DNA (ctDNA). Detecting ctDNA may show that tiny amounts of cancer remain in the body—even before anything is visible on a scan.
Researchers want to know if using this blood test can help doctors decide who should receive immunotherapy after surgery to reduce the chance of the cancer returning.
Two immunotherapy drugs are being studied:
- Nivolumab – helps the immune system recognize and attack cancer cells.
- Relatlimab – works in a similar way but targets a different pathway of the immune system.
The Trial:
In this study, a blood test will be used to check for small traces of cancer DNA (called ctDNA) in patients who have had surgery to remove bladder, kidney, ureter, or urethral cancer.
The main goals of the study are to find out:
- Whether this blood test can help identify patients who still have cancer cells left after surgery, and
- Whether giving immunotherapy drugs (nivolumab alone or together with relatlimab) can help prevent the cancer from coming back and improve survival.
Patients will have a blood test to check for ctDNA (tiny pieces of tumor DNA in the blood). Based on the results, they will be placed into one of two groups.
- Patients with ctDNA will be randomly assigned to receive immunotherapy with either one or two drugs.
- Patients without ctDNA will be randomly assigned to either start immunotherapy right away or be closely monitored and begin treatment only if ctDNA later appears in their blood.
The trial is not “blind”, so both you and your doctor will know which therapy you are receiving.
Basic Eligibility:
- Previously had surgery to remove urothelial carcinoma of the renal pelvis
- Surgery must have been recent — between 3 and 18 weeks before joining the study — with no visible cancer remaining on scans.
Additional eligibility criteria will apply. Please speak to your doctor.
| Hospital / Cancer Centre | Principal Investigator | Location | Trial Status |
|---|---|---|---|
| Hospital / Cancer CentreCross Cancer Institute | Principal InvestigatorScott North | LocationEdmonton, AB | Trial StatusRecruiting |
| Hospital / Cancer CentreBCCA - Vancouver Cancer Centre | Principal InvestigatorBernie Eigl | LocationVancouver, BC | Trial StatusRecruiting |
| Hospital / Cancer CentreWaterloo Regional Health Network | Principal InvestigatorAnupam Batra | LocationKitchener, ON | Trial StatusRecruiting |
| Hospital / Cancer CentreLondon Regional Cancer Program | Principal InvestigatorMelissa Huynh | LocationLondon, ON | Trial StatusRecruiting |
| Hospital / Cancer CentreOttawa Hospital and Cancer Center | Principal InvestigatorChristina Canil | LocationOttawa, ON | Trial StatusRecruiting |
| Hospital / Cancer CentreSunnybrook Health Sciences Centre | Principal InvestigatorSusanna Cheng | LocationToronto, ON | Trial StatusRecruiting |
| Hospital / Cancer CentrePrincess Margaret Hospital | Principal InvestigatorSrikala Sridhar | LocationToronto, ON | Trial StatusRecruiting |

























































