Department of Radiation Oncology, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, China.
The First School of Clinical Medicine, Southern Medical University, Guangzhou, China.
Front Immunol. 2023 Jan 20;14:1115691. doi: 10.3389/fimmu.2023.1115691. eCollection 2023.
Anti-PD-1 immunotherapy has been extensively used in treatment of patients with advanced metastatic renal cell carcinoma (mRCC). Several prospective clinical trials showed that the combined treatment of anti-PD-1 antibody plus lenvatinib, a potent receptor tyrosine kinase inhibitor (TKI), exhibited high response rate compared with single-agent sunitinib. However, whether the patients with primary resistance to PD-1 blockade could benefit from the addition of lenvatinib is still unclear. Herein, we reported a patient with mRCC who was primary resistant to pembrolizumab and achieved a durable complete response after a short-term treatment with lenvatinib. This case report indicates that the patients with primary resistance to anti-PD-1 therapy could benefit from the short-term lenvatinib in combination with anti-PD-1 therapy, and provides a useful paradigm worthy of establishing a clinical trial for mRCC patients with primary resistance to anti-PD-1 therapy.
抗 PD-1 免疫疗法已广泛用于治疗晚期转移性肾细胞癌（mRCC）患者。几项前瞻性临床试验表明，与单药舒尼替尼相比，抗 PD-1 抗体联合强效受体酪氨酸激酶抑制剂（TKI）仑伐替尼的联合治疗具有更高的反应率。然而，对于对 PD-1 阻断剂原发性耐药的患者，仑伐替尼的加入是否有益仍不清楚。在此，我们报告了一例 mRCC 患者，该患者对 pembrolizumab 原发性耐药，在仑伐替尼短期治疗后获得持久的完全缓解。本病例报告表明，对抗 PD-1 治疗原发性耐药的患者可从抗 PD-1 治疗联合短期仑伐替尼中获益，并为建立针对抗 PD-1 治疗原发性耐药的 mRCC 患者的临床试验提供了一个有价值的范例。
