(UroToday.com) The European Society of Medical Oncology (ESMO) 2021 annual congress included a controversial session highlighting ‘Are adjuvant immune checkpoint inhibitors a standard of care for operable high-risk urothelial and kidney cancer?’ Dr. Michiel van der Heijden discussed that no, adjuvant immune checkpoint inhibitors are not standard of care. Dr. van der Heijden started by highlighting that spring 2021 was a happy time: the daily COVID numbers were decreasing, KEYNOTE-564 was presented at ASCO, and CheckMate 274 was published in the New England Journal of Medicine.1 Taking a step back, it is important to remember that the goal of adjuvant therapy is to prevent disease recurrence and death, with the knowledge that a proportion of patients will be treated for a disease that was cured with surgery alone. As such, disease-free survival does not necessarily mean a survival benefit just that the time to disease recurrence was delayed.