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Patients with high-risk locoregional renal cell carcinoma have systemic failure rates greater than 50% after partial or radical nephrectomy. Most studies of adjuvant anti-VEGF tyrosine kinase inhibitors and mTOR inhibitors have failed to demonstrate clinical benefit. The FDA approved the PD-1 antibody pembrolizumab for adjuvant use based on evidence of improved disease-free survival (DFS) from the KEYNOTE 564 study.
Investigators performed an industry-funded multinational phase 3 trial of adjuvant atezolizumab (a PD-L1 antibody) versus placebo in patients with clear-cell renal cancer at increased risk for recurrence after nephrectomy (with or without metastasectomy). Patients were stratified based on disease stage, geographical region, and P…