Neoadjuvant Belzutifan Plus Pembrolizumab in High-Risk, Locally Advanced Clear Cell Renal Cell Carcinoma

The purpose of this study is to compare the safety and effectiveness of two new treatments: belzutifan alone or belzutifan in combination with pembrolizumab before kidney surgery and followed by a combination of belzutifan and pembrolizumab treatment post-surgery. Belzutifan is a small molecule drug that specifically blocks a protein called Hypoxia-Inducible Factor 2 alpha (HIF-2α) and slows down or stops the growth of cancer. Belzutifan has been shown to provide better treatment results in kidney cancer compared to other drugs that target similar proteins to stop cancer growth. Pembrolizumab is a type of medicine called an immunotherapy drug. It helps the immune system spot and attack kidney cancer cells by blocking a "stop sign" that the cancer uses to hide and help slow down or shrink the cancer. The combined use of molecules similar to belzutifan and pembrolizumab has shown promising results in treating kidney cancer, although effectiveness depends on the specific combination. This treatment combination is experimental and is not approved to treat kidney cancer in Australia. This means that it must be tested to see if it is an effective treatment combination for kidney cancer prior to kidney surgery.