Histological complete response with nivolumab for renal cell carcinoma with multiple metastases: A case report

Abstract

The present case report describes a case of left renal clear cell carcinoma with brain, lung, para-aortic, and lymph node metastases (cT1bN1M1) in a 52-year-old Japanese male. The patient received sequential anticancer treatments with pazopanib, everolimus, and axitinib, but exhibited treatment-resistant tumor growth. Treatment with nivolumab resulted in a complete response in metastatic sites. However, the residual renal tumor, which was enhanced by contrast medium, required radical nephrectomy. Pathological analyses of the renal tumor revealed that it consisted of fibrotic and lymphocyte-infiltrated tissues in which morphological cancer cells were not detected. The majority of lymphocytes were cluster of differentiation (CD)8-positive, suggesting that cancer cells were attacked by these lymphocytes. Retrospective analyses of renal cell carcinoma tissues, which were biopsied before the anticancer treatment, revealed their infiltration by CD8-positive T cells. To the best of our knowledge, this is the first case report to examine renal tissue prior to and following treatment with nivolumab using immuno histochemical analysis.

Complete Pathological Response to Neoadjuvant Pembrolizumab in a Patient With Chemoresistant Upper Urinary Tract Urothelial Carcinoma: A Case Report

“…As such, infiltration of CD8 + cells in tumor may potentially predict the effectiveness of pembrolizumab in this case. Similar histological findings had been observed in renal cell carcinoma wherein nivolumab promoted a pathological complete remission (10,11). On the other hand, biopsy and resected specimens had a similar density of CD8 + cells with a high Ki67 expression.…”

Rapid progression of recurrent disease in a patient with renal cell carcinoma with vaginal metastasis

“…The number of CD8-positive T cells in biopsy specimens may predict nivolumab treatment response in metastatic RCC. 9,10 Choueiri et al reported that increased PD-L1 expression in tumor cells and increased number of CD8-positive T cells in the tumor were associated with decreased survival in patients receiving first-line endothelial growth factor receptor-targeting agents (i.e. pazopanib or sunitinib).…”

Immunotherapy in Renal Cell Carcinoma: The Future Is Now

“…Transcriptional analysis identified the up-regulation of genes stimulated by interferon γ with high levels of related chemokine in peripheral blood. A study case reported a histological complete response after nivolumab in metastatic ccRCC [41]. Only fibrotic changes and CD8+ lymphocytes were detected after treatment.…”