Key result
Presurgical ICI therapy linked to ~34 mm average tumor shrinkage in RCC with IVC thrombi.
Why the study?
Does immune checkpoint inhibitor combination therapy reduce tumour size and IVC thrombus height in patients with renal cell carcinoma and concomitant IVC tumour thrombus?
Case Report (n=5)
Does immune checkpoint inhibitor combination therapy reduce tumour size and IVC thrombus height in patients with renal cell carcinoma and concomitant IVC tumour thrombus?
Presurgical immune checkpoint inhibitor therapy may effectively reduce tumour size and IVC thrombus height in select patients with renal cell carcinoma, potentially modifying surgical strategy and reducing surgical risk.
BACKGROUND/AIM: The efficacy of immune checkpoint inhibitor (ICI) combinations in treating inferior vena cava (IVC) tumour thrombi has not yet been reported. We aimed to evaluate the clinical efficacy of ICIs for patients with renal cell carcinoma (RCC) and a concomitant IVC tumour thrombus. PATIENTS AND METHODS: Three men and two women with RCC and an IVC tumour thrombus were administered ICIs in 2020-2021. Three and two patients received nivolumab plus ipilimumab and pembrolizumab plus axitinib therapy, respectively. RESULTS: All ICI-treated patients showed tumour shrinkage. The IVC thrombus level was downstaged in two patients. The mean reduction in maximum primary tumour diameter and IVC thrombus height was 34 and 33 mm, respectively. CONCLUSION: Presurgical ICI therapy in three patients who underwent radical nephrectomy with thrombectomy resulted in a modified surgical strategy and approach and reduced surgical risk. Thus, ICIs may treat select cases of RCC with an IVC tumour thrombus effectively.
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Yoshida et al. (2022) conducted a case report in Renal cell carcinoma with concomitant inferior vena cava tumour thrombus (n=5). Immune checkpoint inhibitor combinations (nivolumab plus ipilimumab or pembrolizumab plus axitinib) was evaluated on Tumour shrinkage. Immune checkpoint inhibitor combination therapy resulted in tumour shrinkage in all 5 patients with RCC and IVC thrombi, with a mean reduction in maximum primary tumour diameter of 34 mm.
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