一名转移性肾细胞癌患者在接受血管生成抑制剂治疗后使用纳武单抗治疗出现病理完全缓解。
Pathological complete response after nivolumab therapy following angiogenesis inhibitors in a patient with metastatic renal cell carcinoma.
作者信息
Hagimoto Hiroki, Kashima Soki, Doi Kazuki, Nakayama Shintaro, Sano Takanori, Imai Satoshi, Yasufuku Tomihiko, Muramaki Mototsugu, Yamada Yuji
机构信息
Department of Urology Hyogo Prefectural Amagasaki General Medical Center Amagasaki Hyogo Japan.
Department of Urology Kyoto University Graduate School of Medicine Kyoto Kyoto Japan.
出版信息
IJU Case Rep. 2020 Oct 5;3(6):287-290. doi: 10.1002/iju5.12220. eCollection 2020 Nov.
INTRODUCTION
Nivolumab is effective for advanced renal cell carcinoma; however, reports are limited wherein nivolumab is combined with sequential therapy of angiogenesis inhibitors and metastasectomy.
CASE PRESENTATION
A 65-year-old man was diagnosed with left renal cell carcinoma of cT2aN0M1 with lung metastasis. The patient underwent nephrectomy and sequential therapy with interferon-α and angiogenesis inhibitors. Lung metastasis decreased by angiogenesis inhibitors, but new right adrenal gland metastasis appeared. Nivolumab as the fifth systemic therapy remarkably shrank the metastasis. After discontinuing nivolumab therapy, the metastasis continued to shrink. The patient underwent adrenalectomy, and pathological analysis revealed no remnant cancer cells in the specimen, confirming a pathological complete response. Twenty months postoperatively, he remains in good health without recurrence.
CONCLUSION
We report a rare case with renal cell carcinoma of a pathological complete response by nivolumab after angiogenesis inhibitors.
引言
纳武单抗对晚期肾细胞癌有效；然而，关于纳武单抗与血管生成抑制剂序贯治疗及转移灶切除术联合应用的报道有限。
病例报告
一名65岁男性被诊断为cT2aN0M1期左肾细胞癌伴肺转移。患者接受了肾切除术，并先后接受了α干扰素和血管生成抑制剂治疗。血管生成抑制剂使肺转移灶缩小，但出现了新的右肾上腺转移。作为第五种全身治疗方案的纳武单抗显著缩小了转移灶。停用纳武单抗治疗后，转移灶继续缩小。患者接受了肾上腺切除术，病理分析显示标本中无残留癌细胞，证实为病理完全缓解。术后20个月，他身体健康，无复发。
结论
我们报告了一例罕见的肾细胞癌病例，在接受血管生成抑制剂治疗后，纳武单抗使其达到病理完全缓解。
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