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Case Reports
. 2022 Feb 23;58(3):336.
doi: 10.3390/medicina58030336.

A Pathological Complete Response to the Combination of Ipilimumab and Nivolumab in a Patient with Metastatic Renal Cell Carcinoma

Hana Studentova  1 , Anezka Zemankova  1 , Martina Spisarova  1 , Daniela Skanderova  2 , Zbynek Tudos  3 , Bohuslav Melichar  1 , Vladimir Student Jr  4
Affiliations
Case Reports

A Pathological Complete Response to the Combination of Ipilimumab and Nivolumab in a Patient with Metastatic Renal Cell Carcinoma

Hana Studentova et al. Medicina (Kaunas). .

Abstract

Background and Objectives: Complete pathological response after ipilimumab and nivolumab combination therapy in a patient with intermediate prognosis renal cell carcinoma is an uncommon finding. Case presentation: A 60-year-old man presented with synchronous solitary metastatic bone lesion and renal cell carcinoma and achieved a complete pathological response after surgical resection of the bone lesion, followed by ipilimumab and nivolumab combination therapy and nephrectomy. The treatment was complicated by hypophysitis and oligoarthritis more than a year after the initiation of the therapy. Conclusions: Currently, the combination therapy based on immune checkpoint inhibitors represents the treatment of choice in patients with intermediate- and poor-risk prognosis metastatic renal cell carcinoma. In the present case, preoperative therapy with ipilimumab and nivolumab resulted in a complete pathological response in the renal tumor. Vigilance concerning potential immune-related side effects is warranted throughout the course of therapy and the subsequent follow-up.

Keywords: hypophysitis; immunotherapy; pathological complete response; renal cell carcinoma.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
(a) Initial contrast-enhanced CT scan in a coronal plane. A tumor on the lower pole of the left kidney contains a heterogeneous enhancing soft-tissue component and a central necrosis. (b) Follow-up contrast-enhanced CT scan in a coronal plane. There is only slight regression of the tumor size, but the soft-tissue component is replaced by hemorrhagic fluid and a thin fibrous wall.
Figure 2
Figure 2
(a) Histopathological examination. A metastatic lesion of clear cell carcinoma to the humerus. (b) Histopathological examination. A metastatic lesion of clear cell carcinoma to the humerus in detail.
Figure 3
Figure 3
Histopathological examination of the primary tumor after radical nephrectomy showing pathological complete response (pCR). Necrosis, lymphocytic infiltrates, but no residual viable tumor cells are present.
See this image and copyright information in PMC

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