EAU 2022 Highlights on Renal Cell Carcinoma

The most debated topic on renal cell carcinoma 9 (RCC) during the EAU 2022 in Amsterdam was 10 the 30 month follow-up update of the Keynote-564 11 trial. In this trial patients with intermediate and high 12 risk for recurrence after nephrectomy with curative 13 intent, and with no evidence of disease at the time of 14 inclusion were randomized between adjuvant treat15 ment with pembroluzimab for 1 year or placebo. 16 A small group of patients with M1 disease who 17 underwent metastasectomy were also included. In 18 the intermediate risk (pT2 with Grade 4 or sarco19 matoid differentiation, N0, M0; pT3, any grade, N0, 20 M0), the high risk (T4, any grade, N0, M0; any pT, 21 any grade, N+, M0) and M1 (no evidence of dis22 ease after surgery) groups disease-free survival was 23 better with pembrolizumab compared with placebo 24 (HR 0·63 [95% CI 0·50–0·80]). Although the median 25 disease-free survival was not reached in any of the 26 groups, the estimated number of participants alive 27 and disease free after 30 months was 75·2% (95% CI 28 70·8–79·1) in the pembrolizumab group and 65·5% 29 (60·9–69·7) in the placebo group [1]. 30 Despite these positive findings the study was much 31 debated during several highlight sessio s. The sur32 vival benefit for the intermediate risk group is less 33 compared to the high risk and M1 groups. This 34 was especially true for those patients with a moder35