This study examines if adding a new cancer drug, tivozanib, to an existing treatment called pembrolizumab works better for patients with high-risk kidney cancer. Pembrolizumab is an immunotherapy, which helps your immune system fight cancer. Tivozanib is a kinase inhibitor, a type of medicine that blocks proteins which help cancer grow.

The study involves two groups: one receives only pembrolizumab, and the other gets both pembrolizumab and tivozanib. Treatments repeat every 12 weeks for up to 4 cycles, and patients will have follow-up checks for several years. Blood samples, imaging tests like MRI or CT scans, and possibly a tissue biopsy will be part of the study.

• This study could last several years due to follow-ups.
• Participants may receive a new combination of medicines.
• There may be risks, like side effects from the medications.

It's important to discuss with your doctor to see if this study is right for you.