Sequential immune-targeted surgical therapy resulted in disease-free survival in a case with advanced renal cell carcinoma.
Aged
Antineoplastic Agents, Immunological
/ administration & dosage
Carcinoma, Renal Cell
/ drug therapy
Disease-Free Survival
Female
Humans
Ipilimumab
/ administration & dosage
Kidney Neoplasms
/ drug therapy
Neoadjuvant Therapy
Nephrectomy
Nivolumab
/ administration & dosage
Protein-Tyrosine Kinases
/ antagonists & inhibitors
Advanced renal cell carcinoma
Case report
Ipilimumab
Nivolumab
Sequential immune-targeted therapy
Journal
BMC urology
ISSN: 1471-2490
Titre abrégé: BMC Urol
Pays: England
ID NLM: 100968571
Informations de publication
Date de publication:
08 Sep 2021
08 Sep 2021
Historique:
received:
24
11
2020
accepted:
31
08
2021
entrez:
9
9
2021
pubmed:
10
9
2021
medline:
8
1
2022
Statut:
epublish
Résumé
Currently, immunotherapy is indicated for patients with metastatic RCC or unresectable RCC, but there is no indication for immunotherapy in the neoadjuvant setting. We report a case in which the combined use of nivolumab and ipilimumab and sequential TKI therapy enabled surgical treatment. A 71-year-old female was diagnosed with a metastatic clear-cell renal cell carcinoma with a level IV tumor thrombus. She was started on nivolumab-ipilimumab therapy, and was switched to pazopanib monotherapy because the tumor thrombus progressed within the right atrium. The tumor shrank to resectable status with sequential therapy. She then underwent right nephrectomy and thrombectomy. Pathological analysis showed 10-20% residual tumor in the primary tumor, but no viable cells in tumor thrombus. She remains clinically disease-free 1 year after surgery. This case suggests the utility of sequential immune-targeted therapy as neoadjuvant therapy in advanced renal cell carcinoma.
Sections du résumé
BACKGROUND
BACKGROUND
Currently, immunotherapy is indicated for patients with metastatic RCC or unresectable RCC, but there is no indication for immunotherapy in the neoadjuvant setting. We report a case in which the combined use of nivolumab and ipilimumab and sequential TKI therapy enabled surgical treatment.
CASE PRESENTATION
METHODS
A 71-year-old female was diagnosed with a metastatic clear-cell renal cell carcinoma with a level IV tumor thrombus. She was started on nivolumab-ipilimumab therapy, and was switched to pazopanib monotherapy because the tumor thrombus progressed within the right atrium. The tumor shrank to resectable status with sequential therapy. She then underwent right nephrectomy and thrombectomy. Pathological analysis showed 10-20% residual tumor in the primary tumor, but no viable cells in tumor thrombus. She remains clinically disease-free 1 year after surgery.
CONCLUSION
CONCLUSIONS
This case suggests the utility of sequential immune-targeted therapy as neoadjuvant therapy in advanced renal cell carcinoma.
Identifiants
pubmed: 34496819
doi: 10.1186/s12894-021-00891-8
pii: 10.1186/s12894-021-00891-8
pmc: PMC8425168
doi:
Substances chimiques
Antineoplastic Agents, Immunological
0
Ipilimumab
0
Nivolumab
31YO63LBSN
Protein-Tyrosine Kinases
EC 2.7.10.1
Types de publication
Case Reports
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
124Informations de copyright
© 2021. The Author(s).
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