Currently, only two adjuvant therapies are approved for high-risk, non-metastatic ccRCC including sunitinib and, more recently, the PD-1 inhibitor pembrolizumab based on improvements in disease-free survival; however, adjuvant sunitinib failed to show an overall survival benefit52, while the overall survival data for adjuvant pembrolizumab currently remains immature53. The gene discussed is PDCD1; the disease is nonpapillary renal cell carcinoma.