Fukunaga Arinobu, Yamasaki Toshinari, Okuno Tomoya, Imai Kazuto, Ikeuchi Ryosuke, Hishiki Kosuke, Goto Takayuki, Sawada Atsuro, Negoro Hiromitsu, Akamatsu Syusuke, Saito Ryoichi, Kobayashi Takashi, Inoue Takahiro, Ogawa Osamu
The Department of Urology, Kyoto University Hospital.
Hinyokika Kiyo. 2018 Oct;64(10):383-389. doi: 10.14989/ActaUrolJap_64_10_383.
Nivolumab was approved as a new agent for advanced renal cell carcinoma (RCC) in Japan on September 2016. Nivolumab is an immune checkpoint inhibitor that activates the cytotoxic immune response and has exerted antitumor effects in a mechanism different from other available molecular targeted agents. Therefore, its response pattern, efficacy and adverse events are different from those of the molecular targeted agents for RCC. Here, we report our initial clinical experience with nivolumab. From December 2016 to September 2017, we applied nivolumab to 7 patients with metastatic RCC. The most common metastatic site was the lungs, followed by lymph nodes, bones and brain. According to the immune-related response criteria, the efficacy was stable disease in 2 patients and progressive disease in 5 patients. In 5 cases with multiple metastases, responses differed with the site of metastasis. The response was best in lung metastasis and worst in brain metastasis. Six cases had minor adverse events. In two cases, we discontinued administration of nivolumab temporarily. The patients recovered completely and we considered nivolumab effective and safe for treatment of metastatic RCC.
2016年9月，纳武单抗在日本被批准作为晚期肾细胞癌（RCC）的一种新药。纳武单抗是一种免疫检查点抑制剂，可激活细胞毒性免疫反应，并以不同于其他现有分子靶向药物的机制发挥抗肿瘤作用。因此，其反应模式、疗效和不良事件与RCC分子靶向药物不同。在此，我们报告我们使用纳武单抗的初步临床经验。2016年12月至2017年9月，我们将纳武单抗应用于7例转移性RCC患者。最常见的转移部位是肺部，其次是淋巴结、骨骼和大脑。根据免疫相关反应标准，2例患者疗效为疾病稳定，5例患者为疾病进展。在5例有多处转移的病例中，不同转移部位的反应有所不同。肺转移的反应最好，脑转移的反应最差。6例有轻微不良事件。2例中，我们暂时停用了纳武单抗。患者完全康复，我们认为纳武单抗对转移性RCC的治疗有效且安全。
