Abstract
INTRODUCTION: Combination therapy comprising immune checkpoint inhibitors and molecular targeted therapies can be effective for metastatic non-clear cell renal cell carcinoma. We describe a patient with metastatic papillary renal cell carcinoma that was completely pathologically resectable after combination treatment comprising lenvatinib and pembrolizumab and robot-assisted radical nephrectomy. CASE PRESENTATION: A 35-year-old man was referred to our department for examination of a renal tumor that was diagnosed as left renal cell carcinoma with lymph node metastasis (cT3aN1M0). Because metastasis affected the renal artery, combination therapy comprising lenvatinib and pembrolizumab was initiated. After 6 months of treatment, the patient underwent robot-assisted radical nephrectomy. The pathological results indicated papillary renal cell carcinoma with no viable cells in the lymph nodes. CONCLUSION: Combination therapy comprising lenvatinib and pembrolizumab for unresectable papillary renal cell carcinoma may effectively allow radical resection and deferred cytoreductive nephrectomy.