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Introduction <p>Recently, treatments for mRCC have drastically changed owing to the development of various types of ICIs, such as PD-1, PD-L1, and CTLA-4, as well as the creation of new types of TKI. However,&#xa0;a standardized approach for the administration of ICIs re-challenge remains unclear.</p> Case presentation <p>In May 2018, a 47-year-old man visited a referral urologist because of macrohematuria. His abdominal contrast-enhanced CT revealed a right kidney tumor, infiltrating the inferior vena cava and spreading multiple times to the lungs. In the same month, an open nephrectomy was performed. He was administered nivolumab (NIVO) and ipilimumab (IPI) for the treatment of metastatic clear cell RCC, but lung metastasis increased in October. Four lines (cabozantinib (CABO), axitinib (AXI), sunitinib (SUN), and pazopanib (PZ)) were administered, but the disease continued to progress. He was then referred to our department, where we recommended a re-challenge with nivolumab as the sixth-line treatment, which he accepted. In March 2022, after six courses of nivolumab, the size of the mediastinal lymph node and multiple lung metastases decreased. In June 2022 when he was administered 12 courses of nivolumab, the metastatic lesion disappeared with a complete response. In December 2022, he continued treatment with nivolumab and maintained a complete response status.</p> Conclusion <p>We report a case of mRCC treated with nivolumab re-challenge. This is the first case report of a complete response achieved with nivolumab re-challenge in a patient with metastatic renal cancer.</p>

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Complete Response in Metastatic Renal Cell Carcinoma with Nivolumab Re-challenge After First-Line IO + Tyrosine Kinase Inhibitors Therapy: a Case Report

  • 期刊论文

  • 发表日期：

    2025年8月6日

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  • Takanori Yoshida,
  • Satoshi Anai,
  • Nobuo Oyama,
  • Kiyohide Fujimoto

摘要

Introduction

Recently, treatments for mRCC have drastically changed owing to the development of various types of ICIs, such as PD-1, PD-L1, and CTLA-4, as well as the creation of new types of TKI. However, a standardized approach for the administration of ICIs re-challenge remains unclear.

Case presentation

In May 2018, a 47-year-old man visited a referral urologist because of macrohematuria. His abdominal contrast-enhanced CT revealed a right kidney tumor, infiltrating the inferior vena cava and spreading multiple times to the lungs. In the same month, an open nephrectomy was performed. He was administered nivolumab (NIVO) and ipilimumab (IPI) for the treatment of metastatic clear cell RCC, but lung metastasis increased in October. Four lines (cabozantinib (CABO), axitinib (AXI), sunitinib (SUN), and pazopanib (PZ)) were administered, but the disease continued to progress. He was then referred to our department, where we recommended a re-challenge with nivolumab as the sixth-line treatment, which he accepted. In March 2022, after six courses of nivolumab, the size of the mediastinal lymph node and multiple lung metastases decreased. In June 2022 when he was administered 12 courses of nivolumab, the metastatic lesion disappeared with a complete response. In December 2022, he continued treatment with nivolumab and maintained a complete response status.

Conclusion

We report a case of mRCC treated with nivolumab re-challenge. This is the first case report of a complete response achieved with nivolumab re-challenge in a patient with metastatic renal cancer.