免疫检查点抑制剂联合治疗合并下腔静脉癌栓的肾细胞癌。
Immune Checkpoint Inhibitor Combination Therapy for Renal Cell Carcinomas With Concomitant Inferior Vena Cava Thrombi.
机构信息
Department of Urology, Tokyo Women's Medical University Hospital, Tokyo, Japan;
Department of Urology, Tokyo Women's Medical University Hospital, Tokyo, Japan.
出版信息
In Vivo. 2022 Mar-Apr;36(2):1030-1034. doi: 10.21873/invivo.12798.
Abstract
BACKGROUND/AIM: The efficacy of immune checkpoint inhibitor (ICI) combinations in treating inferior vena cava (IVC) tumour thrombi has not yet been reported. We aimed to evaluate the clinical efficacy of ICIs for patients with renal cell carcinoma (RCC) and a concomitant IVC tumour thrombus.
PATIENTS AND METHODS
Three men and two women with RCC and an IVC tumour thrombus were administered ICIs in 2020-2021. Three and two patients received nivolumab plus ipilimumab and pembrolizumab plus axitinib therapy, respectively.
RESULTS
All ICI-treated patients showed tumour shrinkage. The IVC thrombus level was downstaged in two patients. The mean reduction in maximum primary tumour diameter and IVC thrombus height was 34 and 33 mm, respectively.
CONCLUSION
Presurgical ICI therapy in three patients who underwent radical nephrectomy with thrombectomy resulted in a modified surgical strategy and approach and reduced surgical risk. Thus, ICIs may treat select cases of RCC with an IVC tumour thrombus effectively.
摘要
背景/目的：免疫检查点抑制剂（ICI）联合治疗下腔静脉（IVC）肿瘤血栓的疗效尚未见报道。我们旨在评估ICI 治疗合并 IVC 肿瘤血栓的肾细胞癌（RCC）患者的临床疗效。
患者和方法
2020 年至 2021 年期间，3 名男性和 2 名女性 RCC 合并 IVC 肿瘤血栓患者接受了 ICI 治疗。其中 3 名和 2 名患者分别接受了纳武利尤单抗联合伊匹单抗和帕博利珠单抗联合阿昔替尼治疗。
结果
所有接受 ICI 治疗的患者均显示肿瘤缩小。2 名患者的 IVC 血栓分级下降。最大原发肿瘤直径和 IVC 血栓高度的平均缩小分别为 34mm 和 33mm。
结论
对 3 例接受根治性肾切除术加血栓切除术的患者进行术前 ICI 治疗，改变了手术策略和方法，降低了手术风险。因此，ICI 可能对选择的 IVC 肿瘤血栓 RCC 病例有效。
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