Response to nivolumab in metastatic collecting duct carcinoma expressing PD‑L1: A case report

Mizutani, Kosuke; Horie, Kengo; Nagai, Shingo; Tsuchiya, Tomohiro; Saigo, Chiemi; Kobayashi, Kazuhiro; Miyazaki, Tatsuhiko; Deguchi, Takashi

doi:10.3892/mco.2017.1449

Cited by 23 publications

(30 citation statements)

References 13 publications

(10 reference statements)

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“…[ 11 , 12 ] However, the correlation between PD-L1 expression and the response rate to nivolumab is unclear. [ 13 ] Mizutani et al [ 8 ] reported that high PD-L1 expression in CDC contributes to a favorable clinical response to nivolumab, and the findings from our case study are in accordance with that study. It can be presumed that the high expression of PD-L1 found in our case was a prognostic indicator of the high malignant potential of the carcinoma and the patient's poor clinical outcome.…”

Section: Discussionsupporting

confidence: 92%

“…Rimar et al [ 7 ] reported the first case in which nivolumab was used in a patient with CDC, who had initially been treated with chemotherapy and subsequently treated with a tyrosine kinase inhibitor; this patient achieved PR with nivolumab therapy. [ 7 ] Mizutani et al [ 8 ] also reported a patient with metastatic CDC who responded well to nivolumab therapy. Moreover, the surgical specimens from this patient highly expressed PD-L1.…”

Section: Discussionmentioning

confidence: 99%

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Nivolumab therapy for metastatic collecting duct carcinoma after nephrectomy

Yasuoka¹,

Hamasaki²,

Kuribayashi³

et al. 2018

Medicine

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Rationale:Collecting duct carcinoma (CDC) is a rare type of nonclear renal cell carcinoma, often presenting at an advanced stage of the disease, and standard treatment guidelines have not been established.Patient concerns:A 73-year-old man was admitted to our hospital with complaints of fever and lower right back pain.Diagnoses:Computed tomography revealed a poorly defined tumor of the right kidney without metastasis. The patient underwent right radical nephrectomy and was diagnosed with clinical stage T1bN0M0 renal cancer; the pathological findings showed collecting duct carcinoma.Interventions:After nephrectomy, multiple lung metastases were found in the following month, so first-line chemotherapy of gemcitabine (1000 mg/m2 on days 1 and 8, every 21 days) and cisplatin (70 mg/m2 on day 2, every 21 days) was administered. Due to disease progression, targeted therapy with axitinib (10 mg/body) and second-line chemotherapy of paclitaxel (200 mg/m2 on day 1, every 21 days) and carboplatin (area under the curve of 6 on day 1, every 21 days) were subsequently administered. However, the lung metastases progressed and new metastases spread to the right adrenal gland, liver, and lymph nodes. Based on the high expression of programmed death-ligand 1 in tumor cells, we treated the patient with the immune checkpoint inhibitor nivolumab.Outcomes:After 2 courses of treatment, he experienced a partial response and improved performance status, and thus was discharged from the hospital. To date, the patient is on his fifth course of treatment as an outpatient without disease progression.Lessons:The findings of our study suggest that nivolumab may be effective even if the patient has highly progressive CDC with a low PS, if PD-L1 is highly expressed in the tumor cells.

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Section: Discussionsupporting

confidence: 92%

Section: Discussionmentioning

confidence: 99%

Nivolumab therapy for metastatic collecting duct carcinoma after nephrectomy

Yasuoka¹,

Hamasaki²,

Kuribayashi³

et al. 2018

Medicine

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“…High-dose interleukin-2 has also demonstrated modest activity in patients with sarcomatoid RCC, with an overall response rate of 10% and a complete response rate of 5%. 59 Case reports 60 – 62 also support the use of nivolumab in non-clear RCC patients. Recently, a more comprehensive retrospective analysis was reported from six centers in the United States, evaluating 41 patients treated with nivolumab of which 14 had unclassified RCC.…”

Section: Introductionmentioning

confidence: 88%

Unclassified renal cell carcinoma: diagnostic difficulties and treatment modalities

Sirohi¹,

Smith²,

Agarwal³

2018

RRU

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Over the past few decades, the classification system of renal cell carcinoma (RCC) variants has witnessed tremendous and ongoing refinement driven by genomic profiling and morphological correlation that have provided valuable insights into tumor biology and characterization of this heterogeneous subset of tumors. The importance of accurate classification cannot be understated given the downstream impact on treatment decisions, risk stratification, and need for genetic testing. While the morphologic heterogeneity across these tumors is increasingly being recognized, all non-clear-cell RCCs are commonly categorized under one therapeutic category with management strategies that largely derive from clear-cell RCCs. As research in metastatic RCC progresses, there is a growing focus on rare subtypes and unclassified tumors, which is rapidly changing the treatment paradigm for non-clear-cell RCC. This review focuses on the histomorphologic diagnostic challenges of unclassified RCCs discussing the utility of contemporary diagnostic tools. It further discusses the current state of knowledge and guidelines for management of this class of tumors.

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“…PD-L1 in TIM showed only a trend to worse OS (29). These results could give a rational to explore immunotherapy in CDC, and there are some case reports with promising activity (30,31).…”

Section: Discussionmentioning

confidence: 73%

Collecting Duct Carcinoma of the Kidney: Analysis of Our Experience at the SPANISH ‘Grupo Centro’ of Genitourinary Tumors

Pinto¹,

Garrido

Aguado

et al. 2019

KCA

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Introduction: Collecting duct carcinomas (CDC), also known as Bellini's tumors, are a rare and aggressive subtype of renal cell carcinoma. Therefore, there are very few data about their management, and there is no standard therapy for this malignancy. We report the outcome of CDC patients treated on institutions belonging to the 'Grupo Centro' of Genitourinary Tumors, a novel networking cooperative group in Spain. Material and Methods: Patients with CDC diagnosed between 1995 and 2015 were included. They had to have an appropriate follow-up, as well as available tissue for further correlative studies. Demographic baseline features and therapy outcomes were collected in a retrospective fashion. Approval for this data collection was obtained from a central ethical committee. Results: A total of 43 patients were analysed, with a median overall survival (OS) of 14 months (95% CI: 9.2-18.8 months). 29 of them (67.4%) were diagnosed as localized disease, and 14 (32.6%) as metastatic disease. For the subgroup of patients diagnosed without metastases, median relapse-free survival (RFS) is 22 months (95% CI: 12.4-35.6 months), and median OS, 53 months (95% CI: 35.5-84.3 months). For the subgroup of patients with metastatic disease, median OS is 6 months (95% CI: 4.1-7.8 months). 16 patients (55.2%) with stage IV disease received systemic therapy, mainly platinum-based chemotherapy, with a response rate of 12.5% and a median progression-free survival (PFS) of 2 months. Conclusions: CDC of the kidney is a malignancy with poor prognosis and few responses to therapy. Median OS of our group in the metastatic setting is similar to what has been observed in previous series. There is a clear need to improve the armamentarium we have for the systemic approach of patients with advanced CDC.

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Response to nivolumab in metastatic collecting duct carcinoma expressing PD‑L1: A case report

Cited by 23 publications

References 13 publications

Nivolumab therapy for metastatic collecting duct carcinoma after nephrectomy

Nivolumab therapy for metastatic collecting duct carcinoma after nephrectomy

Unclassified renal cell carcinoma: diagnostic difficulties and treatment modalities

Collecting Duct Carcinoma of the Kidney: Analysis of Our Experience at the SPANISH ‘Grupo Centro’ of Genitourinary Tumors

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