A case of metastatic renal cell carcinoma with renal impairment that achieved complete remission followed by immune checkpoint inhibitors and partial nephrectomy

Abstract

 A 68-year-old man, with a 3.8 cm sized left kidney tumor invading into left renal vein and lymphadenopathy at the bifurcation of the trachea was diagnosed with metastatic renal cell carcinoma (cT3aN0M1) during scrutiny of renal impairment. He received ipilimumab and nivolumab combination therapy as an initial treatment. After the completion of four cycles of the treatment, the lymph node metastasis disappeared and the size of the primary tumor shrank to 1 cm although the treatment was discontinued due to adrenal insufficiency as an immune-related adverse event. Thus, he underwent a partial nephrectomy and achieved complete remission seven months after the start of the treatment. Twenty-six months after the start of the treatment, his renal function did not worsen compare to that of the initial diagnosis, and no recurrence has been observed.