More clear.
It seems surprising, but there’s no strong data to support adjuvant therapy in patients with resected clear cell renal cell carcinoma (RCC). Sunitinib is an option for patients with stage III clear cell RCC at high risk for relapse, however it doesn’t have much enthusiasm due to a lack of OS improvement and its side effect profile. In KEYNOTE-564, 496 patients with completely resected clear cell RCC and at high risk of recurrence after nephrectomy to adjuvant placebo or pembro for 1 year. High risk included stage II + grade 4 or sarcomatoid differentiation, stage III, LN+, or M1 with no evidence of disease after surgery. Adjuvant pembro significantly increased 24-month DFS from 68.1→ 77.3% with an expected pembro side effect profile. Median OS was not reached yet in either arm. | Choueiri, N Engl J Med 2021
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