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肉瘤样肾细胞癌的免疫治疗:病例报告及文献综述

Immunotherapy treatment for sarcomatoid renal cell carcinoma: case report and literature review.

作者信息

Su Hui, Yu Chao, Ma Xuezhen, Yu Xiao, Sun Guiming

机构信息

Department of Oncology.

The Affiliated Qingdao Central Hospital of Qingdao University, Qingdao Cancer Hospital. Qingdao, Shandong, People's Republic of China.

出版信息

Ann Med Surg (Lond). 2024 Feb 28;86(9):5471-5475. doi: 10.1097/MS9.0000000000001647. eCollection 2024 Sep.

Abstract

INTRODUCTION

Sarcomatoid renal cell carcinoma (SRCC) is clinically rare, accounting for ~1.0-1.5% of renal parenchymal tumors. Although the concept of SRCC was proposed in 1968, the molecular mechanisms and immunological characteristics of sarcomatoid changes remain unclear. In the era of targeted therapy, the overall survival (OS) of patients with SRCC is typically less than 12 months.

CASE PRESENTATION

This article reports a case of SRCC in an 81-year-old male. Progression-free survival (PFS) was as long as 25 months and OS was 30 months after immunotherapy and the effect was significant. This is the first report of successful use toripalimab in the treatment of SRCC.

CLINICAL DISCUSSION

SRCC is a rare type of renal cancer with no obvious specific clinical manifestations or imaging findings, and the diagnosis of the disease is based on pathological examinations. SRCC has a high degree of malignancy, progresses rapidly, and has a poor prognosis. The effect of traditional treatment is limited, and immune checkpoint inhibitors may have therapeutic potential.

CONCLUSIONS

Toripalimab may be effective and further exploration is anticipated to advance a new period of SRCC.

摘要

引言

肉瘤样肾细胞癌(SRCC)临床罕见,占肾实质肿瘤的1.0 - 1.5%。尽管SRCC的概念于1968年提出,但其肉瘤样改变的分子机制和免疫特征仍不清楚。在靶向治疗时代,SRCC患者的总生存期(OS)通常少于12个月。

病例报告

本文报告1例81岁男性SRCC患者。免疫治疗后无进展生存期(PFS)长达25个月,OS为30个月,效果显著。这是首次成功使用托瑞帕利单抗治疗SRCC的报告。

临床讨论

SRCC是一种罕见的肾癌类型,无明显特异性临床表现或影像学表现,该病的诊断基于病理检查。SRCC恶性程度高,进展迅速,预后差。传统治疗效果有限,免疫检查点抑制剂可能具有治疗潜力。

结论

托瑞帕利单抗可能有效,期待进一步探索以开启SRCC治疗的新篇章。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/caf7/11374251/7d87eca622db/ms9-86-5471-g001.jpg

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