(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. Thomas Powles discussed that yes, adjuvant immune checkpoint inhibitors are standard of care. At the moment, there is no approved neoadjuvant or adjuvant therapy for patients with high-risk kidney cancer, but there are several scoring systems to risk-stratify patients. The KEYNOTE-564 trial1 is the first adjuvant checkpoint inhibitor in the adjuvant disease space. Patients randomized to pembrolizumab had a significant disease-free survival benefit compared to those treated with placebo in the intention-to-treat population (HR 0.68, 95% CI 0.53-0.87):