Complete Remission of Bone Metastases in Renal Cell Carcinoma with Nivolumab

Vuyyala, Sowjanya; Gandhi, Shipra; Kuechle, Joseph; George, Saby

doi:10.7759/cureus.5531

Cited by 8 publications

(9 citation statements)

References 10 publications

(10 reference statements)

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“…In both cases, nivolumab, which was introduced as a second-line treatment after the molecular-targeted drug, improved bone metastases. Vuyyala et al (17) reported that a solitary scapular metastasis with osteolytic change was remodeled with osteosclerotic change by nivolumab treatment without the concomitant use of a bone-modifying agent (BMA). Marsh et al (18) reported that the accumulation of a solitary thoracic vertebral body on positron emission tomography (PET) disappeared after nivolumab treatment.…”

Section: Discussionmentioning

confidence: 99%

“…Two case reports have shown that bone metastases from RCC were significantly improved by ICI treatment ( 17 , 18 ). In both cases, nivolumab, which was introduced as a second-line treatment after the molecular-targeted drug, improved bone metastases.…”

Section: Discussionmentioning

confidence: 99%

“…Vuyyala et al. ( 17 ) reported that a solitary scapular metastasis with osteolytic change was remodeled with osteosclerotic change by nivolumab treatment without the concomitant use of a bone-modifying agent (BMA). Marsh et al.…”

Section: Discussionmentioning

confidence: 99%

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Case report: Complete remission of bone metastasis from renal cell carcinoma in histopathological examination after treatment with immune checkpoint inhibitors

Asano

Yamamoto²,

Hayashi³

et al. 2022

Front. Immunol.

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Recently, the prognosis of metastatic renal cell carcinoma (mRCC) has improved owing to the development of immunotherapy using immune checkpoint inhibitors (ICIs). However, there have been few studies on the therapeutic effect of ICIs in bone metastases from renal cell carcinoma (RCC). We report a case in which pulmonary and humeral metastases from RCC were significantly ameliorated using ICIs, while surgery for a pathological fracture of the humerus significantly improved the patient’s quality of life (QoL). A 70-year-old man who underwent a left nephrectomy for RCC developed multiple pulmonary metastases and humeral metastasis with a pathological fracture one year after surgery, and combined treatment with nivolumab and ipilimumab was initiated. After four courses of ICI treatment, multiple pulmonary metastases had almost disappeared, and the tumor at the fracture site had shrunk remarkably. However, the shoulder joint function had decreased due to the fracture, worsening his QoL. Therefore, he underwent surgery and returned to normal daily life one month after. Postoperative histopathological examination of bone and soft tissue at the fracture site revealed no malignancy. To our knowledge, this is the first case report of complete remission of bone metastasis of RCC based on histopathological examination with ICI treatment.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Case report: Complete remission of bone metastasis from renal cell carcinoma in histopathological examination after treatment with immune checkpoint inhibitors

Asano

Yamamoto²,

Hayashi³

et al. 2022

Front. Immunol.

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“…The effect of ICI on the bone metastases of RCC is not clear. There is a case report that nivolumab monotherapy relieved bone metastases in a metastatic RCC patient who underwent radical nephrectomy [ 142 ]. Negishi et al found that ICI monotherapy had limited effects on bone metastases, which may be related to the decrease of PD-L1 expression in bone metastases, while controlled bone metastases and reduced incidence of skeletal-related events emerged when using radiotherapy combined with ICI [ 143 , 144 ].…”

Section: Clinical Effects Of Immune Checkpoint Inhibitors To Bone Metastasismentioning

confidence: 99%

Immune Checkpoint Inhibitor Therapy for Bone Metastases: Specific Microenvironment and Current Situation

Liu

Wang

et al. 2021

Journal of Immunology Research

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The treatment of bone metastases is a thorny issue. Immunotherapy may be one of the few hopes for patients with unresectable bone metastases. Immune checkpoint inhibitors are the most commonly used immunotherapy drugs currently. In this review, the characteristics and interaction of bone metastases and their immune microenvironment were systematically discussed, and the relevant research progress of the immunological mechanism of tumor bone metastasis was reviewed. On this basis, we expounded the clinical application of immune checkpoint inhibitors for bone metastasis of common tumors, including non-small-cell lung cancer, renal cell carcinoma, prostate cancer, melanoma, and breast cancer. Then, the deficiencies and limitations in current researches were summarized. In-depth basic research on bone metastases and optimization of clinical treatment is needed.

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“…Almost half of the patients with clear cell renal cell carcinoma (ccRCC) develop metastases [1]. Even after surgical treatment of early non-metastatic kidney cancer, metastases occur in 5-15% of cases within five years of follow-up, which significantly affect the survival of patients [2].…”

Section: Introductionmentioning

confidence: 99%

The Genes—Candidates for Prognostic Markers of Metastasis by Expression Level in Clear Cell Renal Cell Cancer

et al. 2020

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The molecular prognostic markers of metastasis are important for personalized approaches to clear cell renal cell carcinoma (ccRCC) treatment but markers for practical use are still missing. To address this gap we studied the expression of ten genes—CA9, NDUFA4L2, VWF, IGFBP3, BHLHE41, EGLN3, SAA1, CSF1R, C1QA, and FN1—through RT-PCR, in 56 ccRCC patients without metastases and with metastases. All of these, excluding CSF1R, showed differential and increased (besides SAA1) expression in non-metastasis tumors. The gene expression levels in metastasis tumors were decreased, besides CSF1R, FN1 (not changed), and SAA1 (increased). There were significant associations of the differentially expressed genes with ccRCC metastasis by ROC analysis and the Fisher exact test. The association of the NDUFA4L2, VWF, EGLN3, SAA1, and C1QA expression with ccRCC metastasis is shown for the first time. The CA9, NDUFA4L2, BHLHE4, and EGLN3 were distinguished as the strongest candidates for ccRCC metastasis biomarkers. We used an approach that presupposed that the metastasis marker was the expression levels of any three genes from the selected panel and received sensitivity (88%) and specificity (73%) levels with a relative risk of RR > 3. In conclusion, a panel of selected genes—the candidates in biomarkers of ccRCC metastasis—was created for the first time. The results might shed some light on the ccRCC metastasis processes.

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Complete Remission of Bone Metastases in Renal Cell Carcinoma with Nivolumab

Cited by 8 publications

References 10 publications

Case report: Complete remission of bone metastasis from renal cell carcinoma in histopathological examination after treatment with immune checkpoint inhibitors

Case report: Complete remission of bone metastasis from renal cell carcinoma in histopathological examination after treatment with immune checkpoint inhibitors

Immune Checkpoint Inhibitor Therapy for Bone Metastases: Specific Microenvironment and Current Situation

The Genes—Candidates for Prognostic Markers of Metastasis by Expression Level in Clear Cell Renal Cell Cancer

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