Newly developing brain metastases during nivolumab therapy for metastatic renal cell carcinoma: A case series in two Japanese institutions

Editorial Comment from Dr Kondo to Clinical utility of head computed tomography scan during systemic therapy for metastatic renal cell carcinoma

“…1 However, recent studies have shown that the brain is the most common site of the new metastases at the time of progressive disease during treatment with immune checkpoint inhibitors. 2 Therefore, BM screening might be more important in the new immuno-oncology era of mRCC treatment.…”

“…Shingo Hatakeyama M.D., Ph.D. 1 and Chikara Ohyama M.D. 1,2 Departments of 1 Advanced Blood Purification Therapy and 2 Urology, Hirosaki University Graduate School of Medicine, Hirosaki, Aomori, Japan shingoh@hirosaki-u.ac.jp DOI: 10.1111/iju.14508…”

“…However, BM screening is not strongly recommended according to the guidelines unless patients present with specific clinical symptoms owing to the lack of survival benefit in the early detection of BM or the low incidence of asymptomatic BMs 1 . However, recent studies have shown that the brain is the most common site of the new metastases at the time of progressive disease during treatment with immune checkpoint inhibitors 2 . Therefore, BM screening might be more important in the new immuno‐oncology era of mRCC treatment.…”

Unique behavior of brain metastases during the treatment of nivolumab for metastatic renal cell carcinoma

“…Of these, 8 patients (35%) showed new metastases in the brain, which is the most common site. We recently reported relatively high incidence of newly developed BM (6 out of 21, 28.6%) during nivolumab therapy in RCC (11). Out of 6 patients who developed new lesions in the brain, 4 of them had sustained objective response at the extracranial lesions.…”