The FDA has approved pembrolizumab (Keytruda) plus belzutifan (Welireg) as an adjuvant treatment for adults with high-risk clear cell renal cell carcinoma after surgery, according to a Dana-Farber–cited approval update. The combination pairs a PD-1 checkpoint inhibitor with belzutifan’s HIF-2α blockade, aiming to reduce recurrence risk following nephrectomy or partial resection. The approval expands the adjuvant IO+targeted-treatment playbook in RCC and immediately puts new pressure on competing perioperative regimens, particularly those evaluated in parallel recurrence-prevention settings. Clinicians will now need to align patient selection, dosing, and toxicity management for the two-drug regimen in routine practice.