Bilateral Asynchronous Renal Cell Carcinoma With Lung Metastases: A Case Report of a Patient Treated Solely With High-dose Intravenous and Subcutaneous Viscum album Extract for a Second Renal Lesion

e15603 Background: Five-years survival of patients with metastatic renal cell carcinoma (mRCC) is only 10%. A complete response (CR) to therapy is rare but has been achieved in minority of patients using high-dose interleukin-2. Sunitinib is an oral multitargeted receptor tyrosin kinase inhibitor and is currently considered the standard of care for first-line therapy of mRCC. CRs and long-term responders (LTR) to sunitinib have been documented in the literature. However, a detailed description and analysis of these patients is lacking. We report LTR, defined as patients achieving ongoing CR or remaining progression-free for ≥ 18 months on sunitinib. Methods: From 10/2008 till 12/2012, 48 patients were treated with sunitinib (50 mg/day, 4 weeks on/2 weeks off) as the first line therapy of clear cell mRCC. Tumor assessments were performed at baseline and every two cycles thereafter until the end of treatment, using RECIST criteria. Results: Nine patients were identified as LTR (18.8%). Retrospective data of these patients are reported in the Table. Conclusions: Sunitinib achieves LTR in a subset of patients with mRCC. Lung metastases and favourable MSKCC risk group may predict LTR. Maintaining full-dose sunitinib and management of therapy- related toxicity are crucial for treatment efficacy. [Table: see text]

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Chemoimmunotherapy in Advanced Renal Cell Carcinoma: A Case Report of a Long-Term Survivor Adjunctly Treated with Viscum album Extracts

Complementary Medicine Research ◽

10.1159/000496866 ◽

2019 ◽

Vol 26 (4) ◽

pp. 276-279

Author(s):

Paul G. Werthmann ◽

Lothar Kindermann ◽

Gunver S. Kienle

Keyword(s):

Renal Cell Carcinoma ◽

Case Report ◽

Cell Carcinoma ◽

Metastatic Renal Cell Carcinoma ◽

Renal Cell ◽

Synergistic Effects ◽

Combined Treatment ◽

Interleukin 2 ◽

Viscum Album ◽

Interferon Α2a

Introduction: Metastatic renal cell carcinoma has a poor prognosis. Treatment approaches with immunotherapy show promising results in subpopulations. Viscum album extracts – used as an adjunct to cancer treatment – have cytotoxic, apoptogenic, and immune-stimulating properties and show synergistic effects with chemotherapy agents. Case Report: A 51-year-old man was diagnosed with metastatic renal cell carcinoma of clear cell histology which was classified as pT3a, N1, M1, G3. Nephrectomy was performed, and the patient received chemoimmunotherapy (interferon-α2a, interleukin-2, fluorouracil, isotretinoin). Additionally, he received V. album extracts as intravenous infusions and subcutaneous injections. One year after surgery, the patient was in complete remission, which is ongoing 18 years after the initial diagnosis. Discussion: This case shows an extraordinarily long survival of a metastasized renal cell carcinoma patient under chemoimmunotherapy and fever-inducing V. album extracts. This combined treatment might have synergistically contributed to tumor remission and control. With regard to clinical relevance, further investigations are needed.

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