This clinical trial is focused on studying treatments for renal cell carcinoma, a type of kidney cancer that is locally advanced, cannot be surgically removed, or has spread to other parts of the body. The study involves several medications, including RO7247669 (also known as Tobemstomig), Tiragolumab, Pembrolizumab (marketed as KEYTRUDA), and Axitinib. These medications are used in different combinations to explore their effectiveness and safety in treating this form of cancer.

The purpose of the study is to evaluate how well these combinations work and how safe they are for patients. Participants will receive these medications through an intravenous infusion, which means the medicine is given directly into a vein. The study will compare different groups of patients receiving different combinations of these drugs. One group will receive Tobemstomig and Axitinib, another will receive Tiragolumab, Tobemstomig, and Axitinib, and a control group will receive Pembrolizumab and Axitinib. Some participants may receive a placebo, which is a substance with no active medication, to help compare the effects of the actual drugs.

The study will take place over a period of up to 24 months, during which participants will be monitored for any changes in their condition and any side effects they may experience. The goal is to determine which combination of treatments is most effective in slowing down the progression of the cancer and to assess the overall safety of these treatments. Participants will be closely observed by medical professionals throughout the study to ensure their well-being and to gather important data on the treatments being tested.