Study Overview: This is a Phase II trial testing two drugs, **lenvatinib** and **pembrolizumab**, on patients with kidney cancer that's spread close to its original location but not to distant body parts. **Lenvatinib** helps stop tumor growth by blocking certain enzymes. **Pembrolizumab** is an immunotherapy that helps your immune system attack cancer. The goal is to see if using these drugs before surgery can kill more cancer cells.

Treatment Plan: Patients will take lenvatinib orally once a day and get pembrolizumab intravenously every 21 days. This cycle is repeated four times (12 weeks total). After treatment, patients will be monitored within 14 days, and then every 12 weeks.

• **Duration:** 12 weeks of treatment with follow-ups.
• **Eligibility:** Patients with specific kidney cancer types, good overall health, and certain blood counts.
• **Risks:** Possible side effects from drugs; only suitable for specific medical conditions.

Before participating, patients must provide written consent and meet certain health criteria, such as no recent heart issues, no active infections, or other cancers. Women must use birth control, and men must take precautions if their partners can become pregnant.