Long-term Response to Nivolumab and Acute Renal Failure in a Patient with Metastatic Papillary Renal Cell Carcinoma and a PD-L1 Tumor Expression Increased with Sunitinib Therapy: A Case Report

一例转移性乳头状肾细胞癌患者接受纳武利尤单抗治疗后出现长期疗效及急性肾功能衰竭,且舒尼替尼治疗后PD-L1肿瘤表达升高:病例报告

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Abstract

INTRODUCTION: Papillary renal cell carcinoma (PRCC), which represents around 20% of renal cell carcinomas, is a heterogeneous disease that includes different tumor types with several clinical and molecular phenotypes. Nivolumab, a fully human IgG4 programed cell death protein 1 immune checkpoint inhibitor antibody, has shown not only an overall survival advantage when compared to everolimus but also a relatively good side-effect profile among patients with previously treated advanced or metastatic renal cell carcinoma. CASE REPORT: We describe a case of a young man diagnosed with PRCC that achieved a durable response to nivolumab despite a temporary suspension of the treatment due to a renal function side effect. To the best of our knowledge, it is the first renal failure secondary to nivolumab in a metastatic renal cell carcinoma patient. CONCLUDING REMARKS: Nivolumab is a promising drug in patients with metastatic PRCC and long-term responses can be achieved. In case of acute renal failure secondary to this treatment, temporary therapy suspension and a low dose of systemic corticosteroids can recover renal function without a negative impact on treatment efficacy.

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