Key result
Nivolumab plus ipilimumab achieves complete resolution of right atrial mass in metastatic RCC.
Why the study?
The role of immunotherapy in renal cell carcinoma tumor thrombus extending to the heart is not evidently understood.
Case Report (n=1)
Combination immunotherapy with nivolumab and ipilimumab may lead to complete resolution of right atrial tumor thrombus in patients with metastatic renal cell carcinoma.
Single case of cardiac metastasis resolution with dual ICI in mRCC; hypothesis-generating and requires prospective validation before any practice consideration.
Renal cell carcinoma (RCC) is the most common malignancy of the kidney and has a propensity to metastasizing through the renal vein into the inferior vena cava thereby forming a tumor thrombus which can occasionally enlarge and extend into the right side of the heart. Treatment of RCC has been revolutionized with the introduction of immunotherapy as a standard first line treatment. However, the role of immunotherapy in RCC tumor thrombus extending to the heart is still not evidently understood as of now. Here, we describe a case of a 37-year-old male who presented with unintentional weight loss, shortness of breath, pedal edema and abdominal distension. He was diagnosed with metastatic RCC forming an inferior vena cava tumor thrombus extending to the right atrium and was treated with a combination of nivolumab and ipilimumab, for nine months following which there was a complete resolution of the right atrial tumor mass on imaging.
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Antala et al. (2022) conducted a case report in Metastatic renal cell carcinoma with inferior vena cava tumor thrombus extending to the right atrium (n=1). Nivolumab and ipilimumab was evaluated on Resolution of the right atrial tumor mass on imaging. Treatment with a combination of nivolumab and ipilimumab for nine months resulted in complete resolution of a right atrial tumor mass in a patient with metastatic renal cell carcinoma.
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