For the long-term survival of a patient with renal cell carcinoma and a vena cava tumor thrombus, total resection is desired: inoperable patients are sometimes treated with drugs. The effect of the presurgical use of nivolumab, an anti-programmed cell death 1 (PD-1) antibody drug, has been described. Our patient had inoperable renal cancer with an inferior vena cava tumor thrombus. We were able to downsize the tumor to operable size by administrating nivolumab. The patient underwent a nephrectomy and thrombectomy safely. Pathological findings revealed papillary renal cell carcinoma type 2. No viable cells were identified in the removed thrombus. Anti-programmed cell death ligand 1 was expressed on the cell membrane in approximately 20% of the tumor cells, and PD-1 positive tumor-ifiltrating immune cells had infiltrated particularly at the edge of the tumor. This case indicates the positive effect of the presurgical use of nivolumab for advanced papillary renal cell carcinoma.
Renal cancer Nivolumab Presurgical Papillary renal cell carcinoma
This is a preview of subscription content, log in to check access.
Compliance with ethical standards
Conflict of interest
The authors have no conflict of interest.
It was deemed to be unnecessary for this report.
Informed consent was obtained from the patient.
Blute ML, Leibovich BC, Lohse CM et al (2004) The Mayo Clinic experience with surgical management, complications and outcome for patients with renal cell carcinoma and venous tumour thrombus. BJU Int 94:33–41CrossRefGoogle Scholar
Choueiri TK, Fay AP, Gray KP et al (2014) PD-L1 expression in nonclear-cell renal cell carcinoma. Ann Oncol 25:2178–2184CrossRefGoogle Scholar
Thompson RH (2006) Tumor B7–H1 is associated with poor prognosis in renal cell carcinoma patients with long-term follow-up. Cancer Res 66:3381–3385CrossRefGoogle Scholar
Topalian Suzanne L, Stephen Hodi F et al (2012) Safety and activity of anti-PD-L1 antibody in patients with advanced cancer. N Engl J Med 366:2455–2465CrossRefGoogle Scholar
Geynisman DM (2015) Anti-programmed cell death protein 1 (PD-L1) antibody nivolumab leads to a dramatic and rapid response in papillary renal cell carcinoma with sarcomatoid rhabdoid features. Eur Urol 68:912–914CrossRefGoogle Scholar
Ruiz-Bañobre J, Anido U, Abdulkader I et al (2016) Long-term response to nivolumab and acute renal failure in a patient with metastatic papillary renal cell carcinoma and a PD-L1 tumor expression increased with sunitinib therapy: a case report. Front Oncol 6:250 (eCollection 2016)CrossRefGoogle Scholar
Adrianzen Herrera DA, Fleisig SB, Gartrell BA (2017) Impressive and durable response to nivolumab in a patient with metastatic type 2 papillary renal cell carcinoma: on-label but without evidence. Investig New Drugs 35:665–668CrossRefGoogle Scholar