Before surgery patients will have one of the following:
Cohort 1: pembrolizumab by it self (200mg IV every 3 weeks) for two cycles (6 weeks)
Cohort 2: lenvatinib by it self (8 or 12mg PO once daily according to weight
Cohort 3: combination of pembrolizumab and lenvatinib at the standard doses for 6 weeks
Surgery will take place in a 14-day window between day 50 and day 63 from the start of treatment. Between 8-12 weeks following surgery, all patients will begin treatment with pembrolizumab for up to 12 months.
After surgery everyone has to take pembrolizumab.