Immunotherapy (Nivolumab and Ipilimumab) With and Without a Live Biotherapeutic Product (EXL01) for the Treatment of Metastatic Renal Cell Cancer

This study is testing whether adding a live biotherapeutic product (EXL01 — a gut bacteria treatment) to standard immunotherapy (nivolumab and ipilimumab) improves outcomes for people with advanced kidney cancer. **You may be eligible if...** - You are 18 or older - You have been diagnosed with advanced or metastatic clear cell renal cell carcinoma (a type of kidney cancer) - You have not received prior immunotherapy for your cancer - Your overall health status is adequate (ECOG score of 0–2) - Your life expectancy is more than 3 months **You may NOT be eligible if...** - You have previously received immunotherapy (anti-PD-1, anti-PD-L1, anti-CTLA-4, etc.) - You are currently using probiotics, herbal supplements, or have had a fecal transplant recently - You have an active autoimmune disease - You have a history of severe immune-related side effects from prior medications - You are pregnant or breastfeeding Talk to your doctor to see if this trial is right for you.