Total necrosis after sequential treatment with pazopanib followed by nivolumab in a patient with renal cell carcinoma involving the inferior vena cava

Pathological complete response of renal cell carcinoma with vena cava tumor thrombus to neoadjuvant TKI/IO combination therapy

“…IO drugs have been shown to exert good therapeutic effects in RCC with CD8-positive TILs. Prominent CD8-positive lymphocytic infiltration in necrotic tissue was detected in other cases of RCC that achieved a complete response with IO drugs, 2 similar to the present case. This may show that there was a strong immune response.…”

“…In the ICI era, the reported number of cases with pCR after presurgical therapy with IO monotherapy has been increasing. 2 Labbate et al 3 recently presented a case of RCC in which pCR was achieved with IO combination therapy, andimmunohistochemistry of the tumor and TILs indicated the beneficial effects of neoadjuvant IO. Therefore, expectations are increasing for the therapeutic effects of the combined usage of IO drugs.…”

Pathological complete response after nivolumab therapy following angiogenesis inhibitors in a patient with metastatic renal cell carcinoma

“…Regarding (ii), ICI works remarkably well in certain cases. It has been suggested that pCR is not rare in cases with radiological partial response because not all undergo resection 10–12 . In the present case, we had the option to follow up without surgery.…”

“…It has been suggested that pCR is not rare in cases with radiological partial response because not all undergo resection. [10][11][12] In the present case, we had the option to follow up without surgery. However, cases in which viable cells exist have been reported after a radiographic response was obtained by ICI, 16,17 and we cannot predict whether shrunken lesions include viable cells.…”

“…Including the present case, five cases of RCC that achieved pCR by nivolumab administration have been reported (Table 1). [9][10][11][12] The features that these cases have in common are: (i) all cases were treated with nivolumab following with TKI, and (ii) although the tumor mass shrank by nivolumab and remained on CT, there were no viable cells in the resected tumor. Regarding (i), recent studies have revealed the effectiveness of combination therapies by TKI and ICI as first-line treatments for advanced RCC.…”