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免疫疗法和酪氨酸激酶抑制剂作为透明细胞肾细胞癌转移至甲状腺患者手术的桥梁:一例报告及文献综述

Immunotherapy and Tyrosine Kinase Inhibitor as a Bridge to Surgery for Clear Cell Renal Cell Carcinoma Metastases to the Thyroid: A Case Report and Literature Review.

作者信息

Bränström Robert, Zedenius Jan, Shabo Ivan, Lindskog Magnus, Juhlin C Christofer

机构信息

Department of Breast, Endocrine Tumors, and Sarcoma, Karolinska University Hospital, Stockholm, Sweden.

Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden.

出版信息

Case Rep Oncol. 2024 Oct 9;17(1):1124-1130. doi: 10.1159/000541329. eCollection 2024 Jan-Dec.

Abstract

INTRODUCTION

Clear cell renal cell carcinoma (ccRCC), the most common type of kidney cancer in adults, presents significant challenges owing to its resistance to conventional therapies. Standard treatment primarily revolves around surgical methods, particularly nephrectomy, which is critical for managing localized diseases. Despite recent advancements, the metastatic potential of ccRCC necessitates ongoing vigilance in postoperative monitoring to manage and detect disease recurrence. Recent shifts in treatment paradigms, especially with the integration of molecular patterns in ccRCC, have enabled the development of targeted therapies. Immune checkpoint and tyrosine kinase inhibitors (TKIs) have become central to managing metastatic ccRCC, offering new hope through improved survival outcomes. Recent studies have corroborated this by demonstrating the benefits of combining these therapies.

CASE PRESENTATION

This report discusses a case study of a patient with high-grade ccRCC and thyroid metastases initially deemed non-resectable. The combination of immunotherapy and TKIs reduced tumor size, transforming the thyroid metastasis to a resectable state.

CONCLUSION

This case highlights significant advancements in treatment approaches and the critical in the management of ccRCC, underscoring the necessity for continuous adaptation of clinical practices to incorporate new therapeutic developments.

摘要

引言

透明细胞肾细胞癌(ccRCC)是成人中最常见的肾癌类型,因其对传统疗法具有抗性而带来重大挑战。标准治疗主要围绕手术方法展开,尤其是肾切除术,这对于治疗局限性疾病至关重要。尽管最近取得了进展,但ccRCC的转移潜能使得术后监测仍需持续保持警惕,以管理和检测疾病复发。治疗模式的最新转变,特别是ccRCC中分子模式的整合,推动了靶向疗法的发展。免疫检查点抑制剂和酪氨酸激酶抑制剂(TKIs)已成为治疗转移性ccRCC的核心,通过改善生存结果带来了新希望。最近的研究通过证明联合使用这些疗法的益处证实了这一点。

病例介绍

本报告讨论了一例高级别ccRCC伴甲状腺转移的患者,该患者最初被认为无法切除。免疫疗法和TKIs的联合使用缩小了肿瘤大小,使甲状腺转移灶转变为可切除状态。

结论

该病例突出了治疗方法的重大进展以及ccRCC管理中的关键要点,强调了临床实践不断调整以纳入新治疗进展的必要性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b7ce/11521524/63fb36d8628c/cro-2024-0017-0001-541329_F01.jpg

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