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Case Report: Exceptional response to nivolumab plus cabozantinib in a patient with extrarenal clear cell renal cell carcinoma

Extrarenal clear cell renal cell carcinoma (eccRCC) is a rare type of RCC that arises in areas other than the kidney. Given its rarity, consensus guidelines for optimal treatment of eccRCC have not been established, and the literature is lacking any reports of patient response to systemic therapy an...

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Autores principales: Jansen, Caroline S., Choi, Yujin, Evans, Sean T., Greenwald, Rachel, Behnke, Joseph A., Hartman, Caitlin, Kissick, Haydn, Harik, Lara R., Bilen, Mehmet Asim
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10582703/
https://www.ncbi.nlm.nih.gov/pubmed/37860195
http://dx.doi.org/10.3389/fonc.2023.1271255
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author Jansen, Caroline S.
Choi, Yujin
Evans, Sean T.
Greenwald, Rachel
Behnke, Joseph A.
Hartman, Caitlin
Kissick, Haydn
Harik, Lara R.
Bilen, Mehmet Asim
author_facet Jansen, Caroline S.
Choi, Yujin
Evans, Sean T.
Greenwald, Rachel
Behnke, Joseph A.
Hartman, Caitlin
Kissick, Haydn
Harik, Lara R.
Bilen, Mehmet Asim
author_sort Jansen, Caroline S.
collection PubMed
description Extrarenal clear cell renal cell carcinoma (eccRCC) is a rare type of RCC that arises in areas other than the kidney. Given its rarity, consensus guidelines for optimal treatment of eccRCC have not been established, and the literature is lacking any reports of patient response to systemic therapy and any reports of administration of immunotherapy to patients with ecRCC. Here, we present the case of a patient in their 60s with eccRCC arising in the spleen. The patient underwent splenic resection and then received systemic therapy, due to disease recurrence, with a combination of immunotherapy (IO) and tyrosine kinase inhibitor targeted therapy (VEGF-TKI). The patient had an excellent and durable response to this therapeutic regimen with minimal adverse effects, completing 2 years of therapy of nivolumab and cabozantinib. At the time of this report, the disease remains stable. This case demonstrates that combination therapy with IO+VEGF-TKI represents a reasonable and well-tolerated treatment option with activity in eccRCC and reveals interesting correlative data, including nests of stem-like CD8+T-cell infiltration in tumor tissue, which provide important biological context to this patient’s exceptional therapeutic response.
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spelling pubmed-105827032023-10-19 Case Report: Exceptional response to nivolumab plus cabozantinib in a patient with extrarenal clear cell renal cell carcinoma Jansen, Caroline S. Choi, Yujin Evans, Sean T. Greenwald, Rachel Behnke, Joseph A. Hartman, Caitlin Kissick, Haydn Harik, Lara R. Bilen, Mehmet Asim Front Oncol Oncology Extrarenal clear cell renal cell carcinoma (eccRCC) is a rare type of RCC that arises in areas other than the kidney. Given its rarity, consensus guidelines for optimal treatment of eccRCC have not been established, and the literature is lacking any reports of patient response to systemic therapy and any reports of administration of immunotherapy to patients with ecRCC. Here, we present the case of a patient in their 60s with eccRCC arising in the spleen. The patient underwent splenic resection and then received systemic therapy, due to disease recurrence, with a combination of immunotherapy (IO) and tyrosine kinase inhibitor targeted therapy (VEGF-TKI). The patient had an excellent and durable response to this therapeutic regimen with minimal adverse effects, completing 2 years of therapy of nivolumab and cabozantinib. At the time of this report, the disease remains stable. This case demonstrates that combination therapy with IO+VEGF-TKI represents a reasonable and well-tolerated treatment option with activity in eccRCC and reveals interesting correlative data, including nests of stem-like CD8+T-cell infiltration in tumor tissue, which provide important biological context to this patient’s exceptional therapeutic response. Frontiers Media S.A. 2023-10-04 /pmc/articles/PMC10582703/ /pubmed/37860195 http://dx.doi.org/10.3389/fonc.2023.1271255 Text en Copyright © 2023 Jansen, Choi, Evans, Greenwald, Behnke, Hartman, Kissick, Harik and Bilen https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Oncology
Jansen, Caroline S.
Choi, Yujin
Evans, Sean T.
Greenwald, Rachel
Behnke, Joseph A.
Hartman, Caitlin
Kissick, Haydn
Harik, Lara R.
Bilen, Mehmet Asim
Case Report: Exceptional response to nivolumab plus cabozantinib in a patient with extrarenal clear cell renal cell carcinoma
title Case Report: Exceptional response to nivolumab plus cabozantinib in a patient with extrarenal clear cell renal cell carcinoma
title_full Case Report: Exceptional response to nivolumab plus cabozantinib in a patient with extrarenal clear cell renal cell carcinoma
title_fullStr Case Report: Exceptional response to nivolumab plus cabozantinib in a patient with extrarenal clear cell renal cell carcinoma
title_full_unstemmed Case Report: Exceptional response to nivolumab plus cabozantinib in a patient with extrarenal clear cell renal cell carcinoma
title_short Case Report: Exceptional response to nivolumab plus cabozantinib in a patient with extrarenal clear cell renal cell carcinoma
title_sort case report: exceptional response to nivolumab plus cabozantinib in a patient with extrarenal clear cell renal cell carcinoma
topic Oncology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10582703/
https://www.ncbi.nlm.nih.gov/pubmed/37860195
http://dx.doi.org/10.3389/fonc.2023.1271255
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