My take on #ASCO21 plenary data on adjuvant pembrolizumab for #kidneycancer: Promising DFS results are a good start. It is not surprising that OS is immature. This could very well be the way we treat high-risk localized RCC pts post-nephrectomy in the future. 1/4
9% abs diff in 24 month DFS, corresponds to NNT of 10-11. For stage III melanoma (pembro vs placebo - KEYNOTE-054), abs diff in 24 month RFS was 15-20% depending on stage (NNT 5-6). This will be a nuanced decision in clinic with lots of personalized risk-benefit discussion. 2/4
It would be really helpful to have biomarkers for IO toxicity. G3 treatment-related tox 18% with pembro, 7% required high dose steroids. Continued efforts to identify those most likely to have toxicity (or most likely to benefit) will help us to tailor therapy. 3/4
Overall, this seems to be the most promising systemic adjuvant tx effort in ccRCC thus far. 4/4
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