Could Neoadjuvant Cabozantinib plus Nivolumab followed by Cytoreductive Nephrectomy be the Future Treatment Strategy for Advanced Renal Cell Carcinoma?

Could Neoadjuvant Cabozantinib plus Nivolumab followed by Cytoreductive Nephrectomy be the Future Treatment Strategy for Advanced Renal Cell Carcinoma? by Hung Yi Chen in 

Novel Approaches in Cancer Study



Abstract

Over time, works from oncologists and scientists have contributed to the development of systemic therapies for metastatic renal cell carcinoma (mRCC) with contemporary studies showing superior disease free and overall survival benefits in mRCC patients treated with tyrosine kinase inhibitors (TKI) combined with immune checkpoint inhibitors (ICI). The role of cytoreductive nephrectomy is however still controversial. Here we present with a 57-year-old female patient who suffered from mRCC with left renal vein tumor thrombus, left adrenal, right upper lobe lung and left hip metastases. After 6 months of combination systemic therapy with cabozantinib plus nivolumab, the patient achieved a partial response and received robot assisted laparoscopic cytoreductive nephrectomy (CN). Pathology report of the primary tumor in the left kidney was 85% necrotic and the resected specimens involving the left renal vein thrombus and left adrenal revealed exclusively necrotic tissues. Three months postoperative, an image study showed no evidence of recurrence. Radical nephrectomy after neoadjuvant cabozantinib plus nivolumab in selected patients may achieve disease free status.

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