Table 1.

Choices made to optimize for success for our patients in PROSPER RCC

•The trifecta is necessary—presurgical priming with PD-1 blockade is required for efficacy

•2 neoadjuvant doses of PD-1 inhibition may not be sufficient to eliminate micrometastatic disease and additional adjuvant therapy is warranted

•Nivolumab monotherapy is established as safe and effective in second line metastatic RCC and will be employed as there is currently no proven PD-1 blocking combination therapy

•A higher risk population by stage will be targeted but will be unselected by PD-L1 or other metric as there is no validated predictive marker at present

•Patients will not be subjected to placebo

•A mandatory upfront biopsy will ensure correct RCC diagnosis but also permits unparalleled correlative science