Surgical monotherapy may be a suitable therapeutic strategy for advanced collecting (Bellini) duct carcinoma: A case report and literature review

Zhu, Liang; Wang, Zijian; Pan, Cizhong; Peng, Rui; Xiong, Wei; Zhong, Zhaohui

doi:10.3892/etm.2016.3402

Cited by 7 publications

(4 citation statements)

References 13 publications

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“…1 2 Although surgical treatment is the preferred option for CDC, most patients usually suffer from extensive metastasis with extremely poor prognosis at the time of diagnosis, and thus lost their chance of surgery. 3 Other treatments, such as chemotherapy and target therapy, also showed great potential but generally achieved poor response clinically. 4 Therefore, there is an urgent need to develop novel strategies with high efficacy for CDC.…”

Section: Introductionmentioning

confidence: 99%

Personalized neoantigen-based immunotherapy for advanced collecting duct carcinoma: case report

Zeng

Zhang

et al. 2020

J Immunother Cancer

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BackgroundCollecting duct carcinoma (CDC) of the kidney is a rare and highly aggressive malignant tumor with the worst prognosis among all renal cancers. Nevertheless, the first-line treatments, including chemotherapy and target therapy, usually show poor response to CDC. Recent studies have suggested that immunotherapy targeting personal tumor-specific neoantigens could be a promising strategy for several solid cancers. However, whether it has therapeutic potential in CDC remains unclear.Case presentationHere, we report a case of an Asian patient who underwent personalized neoantigen-based immunotherapy. The patient was diagnosed with metastatic CDC and suffered extensive tumor progression following sorafenib treatment. Based on the patient’s own somatic mutational profile, a total of 13 neoantigens were identified and corresponding long-peptide vaccine and neoantigen-reactive T cells (NRTs) were prepared. After six cycles of neoantigen-based vaccination and T-cell immunotherapy, the patient was reported with stable disease status in tumor burden and significant alleviation of bone pain. Ex vivo interferon-γ enzyme-linked immunospot assay proved the reactivity to 12 of 13 neoantigens in peripheral blood mononuclear cells collected after immunotherapy, and the preferential reactivity to mutant peptides compared with corresponding wild-type peptides was also observed for 3 of the neoantigens. Surprisingly, biopsy sample collected from CDC sites after 3 months of immunotherapy showed decreased mutant allele frequency corresponding to 92% (12/13) of the neoantigens, indicating the elimination of tumor cells carrying these neoantigens.ConclusionsOur case report demonstrated that the combined therapy of neoantigen peptide vaccination and NRT cell infusion showed certain efficacy in this CDC case, even when the patient carried only a relatively low tumor mutation burden. These results indicated that the personalized neoantigen-based immunotherapy was a promising new strategy for advanced CDC.Trial registration numberChiCTR1800017836.

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Section: Introductionmentioning

confidence: 99%

Personalized neoantigen-based immunotherapy for advanced collecting duct carcinoma: case report

Zeng

Zhang

et al. 2020

J Immunother Cancer

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“…According to the literature, most CDC cases are high-grade and advanced, but there is currently no consensus on treatment options. Surgery remains the most effective treatment for kidney cancer patients, even those with advanced disease [ 13 ]. Surgical procedures include radical nephrectomy and partial nephrectomy [ 14 ], but given the high invasiveness of CDC, radical nephrectomy is recommended and may be the only curable opportunity for CDC patients [ 15 , 16 ].…”

Section: Discussionmentioning

confidence: 99%

Collecting duct carcinoma with retroperitoneal mass as initial presentation: a rare case report

Liao

Xia

et al. 2023

BMC Urol

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Background Collecting duct carcinoma (CDC) is a rare renal tumor, originating from the distal collecting duct. CDC rarely presents as a primary tumor outside the renal system. Case presentation In this study, we report a rare case of collecting duct carcinoma, with an initial presentation of retroperitoneal lymph node metastasis, and no identifiable primary renal tumor on CT, at the time of diagnosis. The patient was a 64-year-old man presenting with lower back pain. Preoperative CT showed a round, soft tissue mass, measuring 6.7 × 4.4 × 3.3 cm, in the left retroperitoneum with no exact occupying lesion in the left kidney. Clinically, ectopic pheochromocytoma was considered to be a differential diagnosis, and tumor resection was performed. Postoperative pathological results demonstrated that the mass was a fused lymph node, and the tumor cells were destroying the structure. The final diagnosis was lymph node metastatic collecting duct carcinoma, by histology and immunohistochemistry. No further treatment was performed as no space occupying lesion was found in the kidney. Three months later, CT was reexamined, and a mass of 3.6 cm in diameter, was found in the lower left kidney, along with multiple soft tissue masses, in the left renal hilum. Considering recurrence or metastasis, the patient was recommended to undergo surgical treatment, but the patient refused. Four months later, CT was re-examined. The tumor had rapidly progressed but the patient refused treatment again. As per the author’s press release (eleven months after the first discovery), the patient is still alive. Conclusion CDC is a rare malignant renal carcinoma, with a high chance of rapid progress, regional lymph nodes involvement and metastasis. It presents diagnostic challenges to clinicians and pathologists, particularly, in the absence of radiographically detectable intrarenal lesions. Definite diagnosis is based on pathological examination combined with immunohistochemical staining.

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“…There are no specific guidelines for the treatment of CDC and only a few retrospective studies have analyzed the efficacy of potential treatment [1,4]. The vast majority of patients were initially treated with radical nephrectomy, but there are case reports of nephron sparing surgery (NSS) performed on patients with CDC [4][5][6][7] with a recurrence-free period exceeding twelve months [5,6]. In the study by Matsumoto and coworkers, the clinical outcome of NSS in low grade CDC was excellent.…”

Section: Conflicts Of Interestmentioning

confidence: 99%

Nephron sparing surgery for metastatic collecting duct carcinoma

Kopeć

Kopcza

Wrona

et al. 2019

Cent european J Urol

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Collecting duct carcinoma (CDC) accounts for less than 1% of all renal carcinomas. It is a rare and aggressive neoplasm presenting generally at an advanced stage, and thus has a poor prognosis. The present case describes a 31-year-old female suffering from CDC coexisting with papillary renal cell carcinoma (PRCC) as well as liver, nodal and vertebral metastases. The patient was treated with open nephron sparing surgery. To date, there are only several clinical studies of CDC and few reports of synchronous CDC and PRCC in one kidney.

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Surgical monotherapy may be a suitable therapeutic strategy for advanced collecting (Bellini) duct carcinoma: A case report and literature review

Cited by 7 publications

References 13 publications

Personalized neoantigen-based immunotherapy for advanced collecting duct carcinoma: case report

Personalized neoantigen-based immunotherapy for advanced collecting duct carcinoma: case report

Collecting duct carcinoma with retroperitoneal mass as initial presentation: a rare case report

Nephron sparing surgery for metastatic collecting duct carcinoma

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