Nivolumab + Ipilimumab With Immunostimulatory Embolization for Stage 4 Renal Cell Carcinoma With Unresected Primary

Inclusion Criteria:

Metastatic renal cell carcinoma with unresected primary tumor or with metastasis amenable to embolization.
No prior immune checkpoint therapy

Primary tumor or metastasis amenable to percutaneous embolization per review by the treating interventional oncologist

· Patent feeding artery to tumor > 2 mm diameter without macroscopic arteriovenous fistula/shunt

Additional metastatic site > 1 cm assessable for response by RECIST 1.1

Adequate organ function by screening laboratory studies within 30 days of embolization

platelets > 50K, correctable by transfusion
INR < 1.5, correctable by transfusion
creatinine < 2.0
ECOG performance status 0-2
Age ≥ 18 years
Have signed the current approved informed consent form and be willing and able to comply with this protocol
Women of childbearing potential (WOCBP) must use appropriate method(s) of contraception. WOCBP should use an adequate method to avoid pregnancy for 5 months after the last dose of study drug
Women of childbearing potential must have a negative serum or urine pregnancy test
Men who are sexually active with WOCBP must use any contraceptive method with a failure rate of less than 1% per year Men receiving nivolumab and who are sexually active with WOCBP will be instructed to adhere to contraception for a period of 7 months after the last dose

Exclusion Criteria:

Untreated CNS metastasis
Autoimmune disorder; subjects are permitted to enroll if they have vitiligo, type I diabetes mellitus, residual hypothyroidism due to autoimmune condition only requiring hormone replacement, psoriasis not requiring systemic treatment
Immunodeficiency syndrome
Glucocorticoid (> 10 mg daily prednisone equivalents) or immunosuppressant therapy
Active infection requiring systemic therapy
Any other medical or personal condition that, in the opinion of the site investigator, may potentially compromise the safety or compliance of the patient, or may preclude the patient's successful completion of the clinical trial.
Positive test for hepatitis B virus surface antigen (HBV sAg) or hepatitis C virus ribonucleic acid (HCV antibody) indicating acute or chronic infection
Contrast allergy not mitigated by usual prophylaxis