Kidney Cancer

Question 1

When to use ADJUVANT pembrolizumab?

Answer 1

Stage II (Grade 4 tumors with clear cell histology ± sarcomatoid features)

Stage III Clear cell histology

Stage IV Clear cell histology Metastasectomy with complete resection of disease, followed by adjuvant pembrolizumab within 1 year of nephrectomy

Question 2

FIRST-LINE THERAPY FOR CLEAR CELL HISTOLOGY: Preferred Regimens

Answer 2

Favorable risk:
• Axitinib + pembrolizumab
• Cabozantinib + nivolumab
• Lenvatinib + pembrolizumab

Poor/Intermediate risk:

• Axitinib + pembrolizumab
• Cabozantinib + nivolumab
• Ipilimumab + nivolumab
• Lenvatinib + pembrolizumab
• Cabozantinib

Question 3

SYSTEMIC THERAPY FOR NON-CLEAR CELL HISTOLOGY

Answer 3

Preferred Regimens:
• Clinical trial
• Cabozantinib

Other Regimens:
• Lenvatinib + everolimus
• Nivolumab
• Nivolumab + cabozantinib
• Pembrolizumab
• Sunitinib