Levitin Maria, Ofori Joel, Shin Woo Jae, Huang Jiayi, Daly Mackenzie, Cao Dengfeng, Pachynski Russell
Barbara Ann Karmanos Cancer Institute, Detroit, MI, United States.
Washington University School of Medicine, St. Louis, MO, United States.
Front Oncol. 2020 Sep 23;10:566070. doi: 10.3389/fonc.2020.566070. eCollection 2020.
Renal cell carcinoma (RCC) comprises 4.2% of all new cancer cases in the United States and 30% of cases are metastatic (mRCC) at diagnosis. Brain metastatic RCC historically has poor prognosis, but the development of immune checkpoint inhibitors has revolutionized their care and may be successfully combined with SBRT to improve prognosis. Here, we present a case of a patient with mRCC who had brain metastases treated with concurrent immune checkpoint inhibitors and SBRT. He continues to survive with good functional status years following his initial diagnosis. We discuss the relevant history regarding treatment approach in patients with brain metastatic RCC, ongoing trials focusing on the combination of immunotherapy and radiation, and the potential and promise of the abscopal effect.
肾细胞癌(RCC)占美国所有新发癌症病例的4.2%,30%的病例在诊断时已发生转移(mRCC)。脑转移肾细胞癌历来预后较差,但免疫检查点抑制剂的出现彻底改变了其治疗方式,并且可能与立体定向体部放疗(SBRT)成功联合以改善预后。在此,我们报告1例mRCC患者,其脑转移灶接受了免疫检查点抑制剂与SBRT同步治疗。自初次诊断以来,他多年来一直存活,功能状态良好。我们讨论了脑转移RCC患者治疗方法的相关历史、聚焦免疫治疗与放疗联合的正在进行的试验,以及远隔效应的潜力和前景。