Efficacy of Second-line Cabozantinib after Immune Checkpoint Inhibitor Therapy for Clear Cell Renal Cell Carcinoma with Tumor Thrombus

Abstract

Surgical resection greatly benefits patients with renal cell carcinoma (RCC). However, patients with locally advanced RCC, including tumor thrombus and adjacent organ involvement, are at risk for perioperative complications and perioperative death. Therefore, in some cases, a multimodal approach with systemic therapy should be planned before radical surgery. A 65-year-old female patient with unresectable locally advanced left clear cell carcinoma (ccRCC) with tumor thrombus, who was considered difficult to undergo radical recection, treated with systemic therapy. The tumor responded well to second-line cabozantinib treatment after combination immunotherapy and was completely resected after surgery. This case demonstrates the efficacy of cabozantinib after immune checkpoint inhibition for locally advanced ccRCC and the importance of multimodal therapy in ccRCC.