Comment je prescris le Pembrolizumab en situation adjuvante du carcinome rénal à cellules claires à haut risque de récidive

Abstract

Pembrolizumab is recommended as an adjuvant treatment for clear cell renal cell carcinomas at high risk of recurrence following the release of results from the Phase 3 KEYNOTE-564 trial.It is administered intravenously every 3 or 6 weeks for a period of 12 months. Pre-therapeutic work-up includes a thorough clinical history and examination, a complete blood and urine laboratory test, and a thoraco-abdomino-pelvic CT scan before treatment initiation within 12 weeks postoperatively. Pembrolizumab is estimated to reduce the risk of local or distant recurrence by approximately 37 % and the risk of death by 38 %. Although Pembrolizumab has a favourable safety profile, careful monitoring is required for early detection of possible immunomediated toxicities. This monitoring should be continued beyond the end of treatment.Pembrolizumab is thus the first molecule to demonstrate a benefit in an adjuvant setting in patients with clear cell renal cell carcinoma at intermediate and high risk of recurrence.