Cytoreductive Nephrectomy Promoted Abscopal Effect of Camrelizumab Combined With Radiotherapy for Metastatic Renal Cell Carcinoma: A Case Report and Review of the Literature.
Aged
Antibodies, Monoclonal, Humanized
/ therapeutic use
Carcinoma, Renal Cell
/ immunology
Combined Modality Therapy
Cytoreduction Surgical Procedures
/ methods
Humans
Immune Checkpoint Inhibitors
/ therapeutic use
Kidney Neoplasms
/ immunology
Lymphocyte Culture Test, Mixed
Male
Neoplasm Metastasis
Nephrectomy
/ methods
Radiotherapy Dosage
Receptors, Antigen, T-Cell, alpha-beta
/ physiology
Tumor-Associated Macrophages
/ immunology
MLR
abscopal effect
camrelizumab
clear cell renal cell carcinoma
pseudoprogression
Journal
Frontiers in immunology
ISSN: 1664-3224
Titre abrégé: Front Immunol
Pays: Switzerland
ID NLM: 101560960
Informations de publication
Date de publication:
2021
2021
Historique:
received:
25
12
2020
accepted:
28
05
2021
entrez:
2
7
2021
pubmed:
3
7
2021
medline:
28
9
2021
Statut:
epublish
Résumé
There is little evidence around Camrelizumab combined with cytoreductive nephrectomy (CN) and radiotherapy (RT) as a treatment option for metastatic renal cell carcinoma (mRCC). The influence of CN on immune responses and the abscopal effect are not well understood. In this paper, we report a case of anti-programmed cell death-1 (PD-1) treated with combined RT once CN reduced the primary tumor burden (TB). This patient also encountered an increased response to targeted radiotherapy after immune resistance. We also observed a macrophage-to-lymphocyte ratio (MLR) peak, which may be correlated with subsequent pseudoprogression after thoracic radiotherapy. Consequently, even with the disease, this patient has remained stable. This peculiar instance suggests there is a need to investigate the underlying mechanisms of CN in promoting the abscopal effect during immunotherapy when combined with RT. It also suggests that there is a need for further investigation into the role of RT in overcoming immune resistance, and the value of MLR in predicting pseudoprogression. We hypothesize that a heavy tumor burden might suppress the abscopal effect, thereby ensuring that CN promotes it. However, radiotherapy may overcome immune resistance during oligoprogression.
Identifiants
pubmed: 34211459
doi: 10.3389/fimmu.2021.646085
pmc: PMC8239433
doi:
Substances chimiques
Antibodies, Monoclonal, Humanized
0
Immune Checkpoint Inhibitors
0
Receptors, Antigen, T-Cell, alpha-beta
0
camrelizumab
73096E137E
Types de publication
Case Reports
Journal Article
Research Support, Non-U.S. Gov't
Review
Langues
eng
Sous-ensembles de citation
IM
Pagination
646085Informations de copyright
Copyright © 2021 Wu, Liu, Seery, Meng and Yue.
Déclaration de conflit d'intérêts
The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.
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