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一例集合管型肾癌患者对靶向药物与免疫检查点抑制剂联合治疗的持久反应:病例报告及文献综述

Persistent Response to a Combination Treatment Featuring a Targeted Agent and an Immune Checkpoint Inhibitor in a Patient With Collecting Duct Renal Carcinoma: A Case Report and Literature Review.

作者信息

Zhou Weimin, Huang Ji, He Qiuming, Luo Qingfeng, Zhang Xiaofang, Tao Xuewei, Dong Hanzhi, Tu Xinhua

机构信息

Department of Urology, Jiangxi Cancer Hospital of Nanchang University, Jiangxi Cancer Center, Nanchang, China.

Department of Pathology, Jiangxi Cancer Hospital of Nanchang University, Jiangxi Cancer Center, Nanchang, China.

出版信息

Front Oncol. 2021 Nov 8;11:764352. doi: 10.3389/fonc.2021.764352. eCollection 2021.

Abstract

Collecting duct carcinoma (CDC) is a rare and highly aggressive subtype of kidney cancer that is associated with a poor prognosis. At present, there is no effective treatment for CDC. Herein, we report a case of metastatic CDC treated with a combination of a tyrosine kinase inhibitor and an immune checkpoint inhibitor. A 67-year-old male was diagnosed with CDC with lung and bone metastasis. Pazopanib and camrelizumab were administered after cytoreductive nephrectomy. The patient achieved a partial response after one cycle of treatment; however, he then experienced serious drug-induced hepatic injury. Therefore, we discontinued camrelizumab and administered monotherapy with pazopanib. Three months later, the cancer had progressed and axitinib and sintilimab were administered. The patient achieved a partial response, accompanied by the complete disappearance of the metastatic lesion in the lung. The patient had an excellent physical status after 11 months. This is the first reported case of metastatic CDC successfully treated with a combination of a tyrosine kinase inhibitor and an immune checkpoint inhibitor. This form of combination treatment may be an effective option for treating metastatic CDC.

摘要

集合管癌(CDC)是一种罕见且侵袭性很强的肾癌亚型,预后较差。目前,尚无针对CDC的有效治疗方法。在此,我们报告一例采用酪氨酸激酶抑制剂和免疫检查点抑制剂联合治疗的转移性CDC病例。一名67岁男性被诊断为伴有肺和骨转移的CDC。在减瘤性肾切除术后给予帕唑帕尼和卡瑞利珠单抗治疗。患者在一个治疗周期后达到部分缓解;然而,随后他出现了严重的药物性肝损伤。因此,我们停用了卡瑞利珠单抗,给予帕唑帕尼单药治疗。三个月后,癌症进展,给予阿昔替尼和信迪利单抗治疗。患者达到部分缓解,同时肺部转移病灶完全消失。11个月后患者身体状况良好。这是首例报道的采用酪氨酸激酶抑制剂和免疫检查点抑制剂联合成功治疗转移性CDC的病例。这种联合治疗形式可能是治疗转移性CDC的有效选择。

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