Conclusion
RCC, multiple cancer
MULTIPLE CANCER, RECRUITMENT, MAY, DISEASE, RCC
REFINE is a randomised, phase II, MAMS adaptive basket trial investigating extended interval administration of ICI across multiple cancer types. Eligible patients are those responding (radiologically) to ICI at 12 weeks. The REFINE RCC cohort opened to recruitment on the 25th May 2022 and the first patient was randomised on 22nd August 2022. Subsequent cohorts will be added in the next 12 months. Stage I will recruit 160 patients to each cohort who will be randomised to SOC versus extended dose interval. Disease control will be analysed 6 months from completion of stage I recruitment, and this will inform stage II which will investigate up to 5 different treatment intervals. The REFINE Translational sub-study will investigate the pharmacokinetic and pharmacodynamic aspects of extended interval ICI treatment and health economic evaluation will evaluate the cost effectiveness of extended interval ICI.Completion of the first 2 stages of REFINE will inform the design of a phase III trial testing extended dosing interval of administration of different ICI in responding patients across multiple indications. REFINE is being run in parallel with REFINE-LUNG, a phase III trial evaluating extending the interval of pembrolizumab in advanced non-small-cell-lung-cancer(NSCLC) [Extending the interval of ICIs has potential benefits in improving patients' quality of life, via both reduced side effects and fewer hospital visits, and in more efficient use of healthcare services via lower drug treatment and attendance costs. REFINE and REFINE-Lung have joined a growing initiative of studies aiming to optimise treatment with ICI and these studies should be supported [An up-to-date version of the REFINE protocol can be found at: 
The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.
The trial is currently open to recruitment.