Case Report: Exceptional response to nivolumab plus cabozantinib in a patient with extrarenal clear cell renal cell carcinoma

Frontiers in Oncology

Oncology

Mehmet Asim Bilen¹  Caitlin Hartman¹  Yujin Choi¹  Caroline S. Jansen²  Sean T. Evans³  Rachel Greenwald⁴  Joseph A. Behnke⁵  Lara R. Harik⁶  Haydn Kissick⁷ 

[1] Department of Hematology and Medical Oncology, Emory University School of Medicine, Atlanta, GA, United States;Winship Cancer Institute of Emory University, Atlanta, GA, United States;Department of Hematology and Medical Oncology, Emory University School of Medicine, Atlanta, GA, United States;Winship Cancer Institute of Emory University, Atlanta, GA, United States;Emory University School of Medicine, Atlanta, GA, United States;Department of Medicine, Emory University School of Medicine, Atlanta, GA, United States;Department of Urology, Emory University School of Medicine, Atlanta, GA, United States;Emory University School of Medicine, Atlanta, GA, United States;Winship Cancer Institute of Emory University, Atlanta, GA, United States;Department of Pathology and Laboratory Medicine, Emory University School of Medicine, Atlanta, GA, United States;Winship Cancer Institute of Emory University, Atlanta, GA, United States;Department of Urology, Emory University School of Medicine, Atlanta, GA, United States;

关键词: case report;    extrarenal clear cell renal cell carcinoma;    splenic renal cell carcinoma;    nivolumab;    cabozantinib;    immunotherapy;    targeted therapy;    tyrosine kinase;   

DOI  :  10.3389/fonc.2023.1271255

 received in 2023-08-02, accepted in 2023-09-12,  发布年份 2023

来源: Frontiers

【 摘 要 】

Extrarenal clear cell renal cell carcinoma (eccRCC) is a rare type of RCC that arises in areas other than the kidney. Given its rarity, consensus guidelines for optimal treatment of eccRCC have not been established, and the literature is lacking any reports of patient response to systemic therapy and any reports of administration of immunotherapy to patients with ecRCC. Here, we present the case of a patient in their 60s with eccRCC arising in the spleen. The patient underwent splenic resection and then received systemic therapy, due to disease recurrence, with a combination of immunotherapy (IO) and tyrosine kinase inhibitor targeted therapy (VEGF-TKI). The patient had an excellent and durable response to this therapeutic regimen with minimal adverse effects, completing 2 years of therapy of nivolumab and cabozantinib. At the time of this report, the disease remains stable. This case demonstrates that combination therapy with IO+VEGF-TKI represents a reasonable and well-tolerated treatment option with activity in eccRCC and reveals interesting correlative data, including nests of stem-like CD8+T-cell infiltration in tumor tissue, which provide important biological context to this patient’s exceptional therapeutic response.

【 授权许可】

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Copyright © 2023 Jansen, Choi, Evans, Greenwald, Behnke, Hartman, Kissick, Harik and Bilen