The role of immunotherapy in adj./mRCC, updated evidence and clinical practice

Adjuvant therapy in Renal Cell Carcinoma (RCC) is crucial for improving outcomes, especially in patients at high risk of recurrence after nephrectomy (surgical removal of the kidney). It aims to eliminate residual cancer cells and reduce the likelihood of the disease returning or spreading. The importance of adjuvant therapy in RCC stems from the fact that even after successful surgery, a significant portion of patients still experience progression or recurrence. Partial or radical nephrectomy is the standard-of-care treatment for locoregional clear-cell renal-cell carcinoma. Nevertheless, nearly half the patients will eventually have disease recurrence after surgery, with most of these patients having distant metastases, leading to a substantially shortened life expectancy. Adjuvant pembrolizumab was associated with a significant and clinically meaningful improvement in overall survival, as compared with placebo, among participants with clear-cell renal-cell carcinoma at increased risk for recurrence after surgery.