Abstract
Background and Objectives: Complete pathological response after ipilimumab and nivolumab combination therapy in a patient with intermediate prognosis renal cell carcinoma is an uncommon finding. Case presentation: A 60-year-old man presented with synchronous solitary metastatic bone lesion and renal cell carcinoma and achieved a complete pathological response after surgical resection of the bone lesion, followed by ipilimumab and nivolumab combination therapy and nephrectomy. The treatment was complicated by hypophysitis and oligoarthritis more than a year after the initiation of the therapy. Conclusions: Currently, the combination therapy based on immune checkpoint inhibitors represents the treatment of choice in patients with intermediate- and poor-risk prognosis metastatic renal cell carcinoma. In the present case, preoperative therapy with ipilimumab and nivolumab resulted in a complete pathological response in the renal tumor. Vigilance concerning potential immune-related side effects is warranted throughout the course of therapy and the subsequent follow-up.
Highlights
Publisher’s Note: MDPI stays neutralImmuno-oncology (IO) is promising in solid tumors with a high burden of immunogenic antigens, such as melanoma and non-small cell lung carcinoma (NSCLC)and presents a great opportunity to control the disease in patients with these tumors
/or disease-free survival (DFS) in patients treated with chemotherapy and targeted therapy [2,3,4,5]
Pathological complete response induced by PD-1 blockade might reflect a state of immune activation [6]
Summary
Immuno-oncology (IO) is promising in solid tumors with a high burden of immunogenic antigens, such as melanoma and non-small cell lung carcinoma (NSCLC). As ICIs have become a widely accepted standard of care in many cancer types [1], and because of growing evidence of pathological complete response (pCR) as a surrogate efficacy endpoint, many clinical trials have started recruitment of patients with various solid tumors employing an anti-PD1 strategy in the preoperative setting. Combination immunotherapy with PD-1 and CTLA-4 inhibitors has shown high complete and overall response rates in metastatic setting, and the therapy is being evaluated in multiple clinical trials to investigate the benefit in the preoperative setting [7,8]. We present a case of metastatic RCC (mRCC) with a solitary metastatic lesion to the bone surgically removed and subsequently treated with combination immunotherapy, resulting in a complete pathological response of the renal primary
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