scholarly journals Durable Remission with Immunotherapy in a Patient with Sarcomatoid Renal Cell Carcinoma

2021 ◽  
Vol 8 (4) ◽  
pp. 38-42
Author(s):  
Nwabundo Anusim ◽  
Damilola Gbadebo ◽  
Olabisi Afolayan-Oloye ◽  
Ishmael Jaiyesimi
Keyword(s):  
Renal Cell Carcinoma ◽  
Cell Death ◽  
Programmed Cell Death ◽  
Cell Carcinoma ◽  
Renal Cell ◽  
Therapy Response ◽  
Histologic Subtype ◽  
Attractive Option ◽  
Sarcomatoid Renal Cell Carcinoma ◽  
Sarcomatoid Differentiation

Sarcomatoid differentiation is a rare and aggressive histologic subtype with poor prognosis, seen in several malignancies. In sarcomatoid renal cell carcinoma (RCC), the degree of sarcomatoid differentiation and the stage at presentation determines the prognosis. Despite resection, chemotherapy and targeted therapy response is modest, with relapse usually occurring within a few months. We present a case of a gentleman with sarcomatoid RCC managed with pembrolizumab, who has had no evidence of recurrence for over 4 years since the last dose of immunotherapy. RCCs with sarcomatoid differentiation have a high presence of programmed cell death protein 1 and programmed cell death ligand 1 in T cells and tumor cells, respectively, making immunotherapy an attractive option in this setting. Clinical trials are ongoing to further define the benefit of immunotherapy in sarcomatoid RCC.

scholarly journals Programmed cell death ligand 1 and tumor‐infiltrating lymphocyte status in patients with renal cell carcinoma and sarcomatoid dedifferentiation

Cancer ◽  
2017 ◽  
Vol 123 (24) ◽  
pp. 4823-4831 ◽  
Author(s):  
Fumi Kawakami ◽  
Kanishka Sircar ◽  
Jaime Rodriguez‐Canales ◽  
Bryan M. Fellman ◽  
Diana L. Urbauer ◽  
...  
Keyword(s):  
Renal Cell Carcinoma ◽  
Cell Death ◽  
Programmed Cell Death ◽  
Cell Carcinoma ◽  
Renal Cell ◽  
Tumor Infiltrating Lymphocyte

scholarly journals Resumption of anti‐programmed cell death 1 monotherapy for severe immune‐related adverse events experienced patient with renal cell carcinoma

2020 ◽  
Vol 3 (5) ◽  
pp. 176-179 ◽  
Author(s):  
Yoko Maegawa ◽  
Taigo Kato ◽  
Shinichiro Fukuhara ◽  
Hiroshi Kiuchi ◽  
Ryoichi Imamura ◽  
...  
Keyword(s):  
Renal Cell Carcinoma ◽  
Cell Death ◽  
Programmed Cell Death ◽  
Adverse Events ◽  
Cell Carcinoma ◽  
Renal Cell ◽  
Experienced Patient ◽  
Programmed Cell Death 1

Results of a phase II study of atezolizumab and bevacizumab in non-clear cell renal cell carcinoma (nccRCC) and clear cell renal cell carcinoma with sarcomatoid differentiation (sccRCC).

2019 ◽  
Vol 37 (7_suppl) ◽  
pp. 548-548 ◽  
Author(s):  
Rana R. McKay ◽  
Bradley Alexander McGregor ◽  
Kathryn Gray ◽  
John A. Steinharter ◽  
Meghara K. Walsh ◽  
...  
Keyword(s):  
Renal Cell Carcinoma ◽  
Adverse Events ◽  
Cell Carcinoma ◽  
Phase Ii ◽  
Renal Cell ◽  
Clear Cell ◽  
Collecting Duct ◽  
Cell Renal Cell Carcinoma ◽  
Histologic Subtype ◽  
Sarcomatoid Differentiation

548 Background: NccRCC and sccRCC have historically been underrepresented in clinical trials. Even with targeted therapy, most patients have inferior survival compared to clear cell renal cell carcinoma. The combination of atezolizumab and bevacizumab has demonstrated safety and efficacy in ccRCC. In this multicenter, phase II, open-label, single arm trial we evaluate the efficacy of atezolizumab and bevacizumab in patients with nccRCC and sccRCC with >20% sarcomatoid differentiation. Methods: Eligible patients had an ECOG performance status of 0-2 and may have received prior therapy. Prior PD-1/PD-L1 therapy was not allowed. Patients underwent a mandatory baseline biopsy and subsequently received atezolizumab 120 mg and bevacizumab 15 mg/kg intravenously every 3 weeks. Patients remained on therapy until radiographic progression, unacceptable adverse events, or withdrawal. The primary end point was overall response rate (ORR) as determined by RECIST version 1.1. Results: 65 patients were enrolled of whom 52 had ≥1 response assessment and were included in this analysis. 36 patients had nccRCC (papillary n=14, chromophobe n=8, unclassified RCC n=3, collecting duct n=3, translocation n=3, other n=5), and 16 patients had sccRCC. 17 patients received prior systemic therapy, 16 of whom had nccRCC. The ORR was 31% in the overall cohort (Table 1). 10 patients (19%) developed grade 3 treatment-related adverse events (AEs), half of which were immune-related. There were no grade 4-5 AEs. Conclusions: In this study, we show that therapy with atezolizumab and bevacizumab was safe and demonstrated anti-tumor activity in nccRCC and sccRCC. Further analyses will report ORR by histologic subtype and PD-L1 expression status. Analysis of tissue and blood-based biomarkers of response are ongoing. Clinical trial information: NCT02724878. [Table: see text]

Sarcomatoid renal-cell carcinoma: treatment strategy, review of the literature and a case report

Oncoreview ◽  
2016 ◽  
Vol 6 (4) ◽  
pp. 0-0 ◽  
Author(s):  
Agnieszka Gębara-Puchniarz ◽  
Beata Hryciuk ◽  
Rafał Stec ◽  
Cezary Szczylik ◽  
Bartłomiej Grala ◽  
...  
Keyword(s):  
Renal Cell Carcinoma ◽  
Cell Carcinoma ◽  
Renal Cell ◽  
Clear Cell ◽  
Systemic Treatment ◽  
Clear Cell Carcinoma ◽  
Standards Of Care ◽  
Histologic Subtype ◽  
Sarcomatoid Renal Cell Carcinoma ◽  
Line Chemotherapy

Introduction: Sarcomatoid renal-cell carcinoma is a very rare cancer characterised with aggressive course of disease and poor prognosis. At present there are no standards of care for this histologic subtype of renal cell carcinoma resistant to various forms of systemic treatment. Methods: The study describes a case of 58 year old woman after left nephrectomy for clear cell carcinoma with sarcomatoid component and after resection of right-kidney tumour for synchronous clear cell carcinoma who received first-line bevacizumab and temsirolimus under the clinical trial, and then second-line chemotherapy based on gemcitabine and doxorubicin and ifosfamide-based third-line chemotherapy. The patient underwent pulmonary metastasectomy twice, and once a metastasectomy for liver metastases. Conclusions: Surgery (including metastases treatment) followed by the systemic chemotherapy seems to be correct option of treatment in patients with renal cell carcinoma with sarcomatoid features. The development of optimum method of systemic treatment requires further prospective randomised trials.

Atezolizumab-induced type 1 diabetes mellitus in a patient with metastatic renal cell carcinoma

2020 ◽  
Vol 13 (7) ◽  
pp. e233842 ◽  
Author(s):  
Wedad Rahman ◽  
Anna Conley ◽  
Kristi D Silver
Keyword(s):  
Renal Cell Carcinoma ◽  
Cell Death ◽  
Type 1 Diabetes ◽  
Programmed Cell Death ◽  
Cell Carcinoma ◽  
Metastatic Renal Cell Carcinoma ◽  
Renal Cell ◽  
Checkpoint Inhibitor ◽  
Autoimmune Reaction

Checkpoint inhibitor immunotherapy has revolutionised cancer treatment since its inception. During an inflammatory response, activated cytotoxic T cells expressing programmed cell death protein 1 (PD-1) interact with programmed cell death-ligand 1 (PD-L1) on peripheral tissues to thwart an autoimmune reaction. Cancer cells upregulate PD-L1 expression to evade the immune system and are vulnerable to attack in the presence of PD-1 or PD-L1 checkpoint inhibitors. However, blockade of this pathway also contributes to the unintended side effect of autoimmune endocrinopathies. Atezolizumab, a checkpoint inhibitor against PD-L1, is associated with the rare complication of type 1 diabetes. We present a case of glutamic acid decarboxylase antibody-positive type 1 diabetes developing in a patient with a long-standing history of well-controlled type 2 diabetes following treatment with atezolizumab for metastatic renal cell carcinoma.

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