Department of Internal Medicine, University of Arkansas for Medical Sciences, Little Rock, AR.
Division of Hematology- Oncology, Department of Internal Medicine, University of Arkansas for Medical Sciences, Little Rock, AR.
Clin Genitourin Cancer. 2020 Dec;18(6):e688-e691. doi: 10.1016/j.clgc.2020.04.003. Epub 2020 Apr 21.
Nephrectomy is the reference-standard treatment for renal-cell carcinoma (RCC). For patients with unresectable disease, tumor may be shrunk by using chemotherapy, thereby permitting surgical resection, which can be curative. We provided neoadjuvant cabozantinib, the preferred tyrosine kinase inhibitor for advanced RCC of poor and intermediate risk, to two patients with initially unresectable RCCs. In both patients, this led to tumor shrinkage of > 50% after 4 months of therapy, which permitted surgical resection. Both tumor specimens also showed strong pathologic tumor response. The robust responses observed with cabozantinib, even at reduced doses, suggest it to be an effective neoadjuvant option in RCC. Our novel experience with neoadjuvant cabozantinib, combined with our review of the use of cabozantinib in RCC, indicates that providing preoperative cabozantinib to facilitate potentially curative surgical resection has good results and should be further explored.
肾切除术是肾细胞癌（RCC）的标准治疗方法。对于不可切除疾病的患者，肿瘤可以通过化疗缩小，从而允许进行手术切除，这可能是治愈性的。我们为两名最初不可切除的 RCC 患者提供了新辅助卡博替尼治疗，卡博替尼是晚期低危和中危 RCC 的首选酪氨酸激酶抑制剂。在这两名患者中，在 4 个月的治疗后，肿瘤缩小了 >50%，从而允许进行手术切除。两个肿瘤标本也显示出强烈的病理性肿瘤反应。卡博替尼观察到的强劲反应，即使在降低剂量下，也表明其是 RCC 有效的新辅助治疗选择。我们在新辅助卡博替尼方面的新经验，结合我们对卡博替尼在 RCC 中的使用的回顾，表明术前给予卡博替尼以促进潜在的治愈性手术切除具有良好的效果，应该进一步探索。
