Complete Pathologic Response to Pembrolizumab and Axitinib in a Patient With Sarcomatoid RCC and Ocrelizumab-Treated Multiple Sclerosis

Kevin Neuzil; Kathryn Gessner; John Hedgepeth; Sara E Wobker; Eric M Wallen; Katherine P Morgan; Marc A Bjurlin; Tracy L Rose

doi:10.1016/j.urology.2021.12.015

Complete Pathologic Response to Pembrolizumab and Axitinib in a Patient With Sarcomatoid RCC and Ocrelizumab-Treated Multiple Sclerosis

Urology. 2022 Jun:164:50-54. doi: 10.1016/j.urology.2021.12.015. Epub 2021 Dec 29.

Authors

Kevin Neuzil¹, Kathryn Gessner¹, John Hedgepeth², Sara E Wobker², Eric M Wallen³, Katherine P Morgan⁴, Marc A Bjurlin³, Tracy L Rose⁵

Affiliations

¹ Department of Urology, University of North Carolina at Chapel Hill, Chapel Hill, NC.
² Department of Pathology, University of North Carolina at Chapel Hill, Chapel Hill, NC.
³ Department of Urology, University of North Carolina at Chapel Hill, Chapel Hill, NC; Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC.
⁴ Department of Pharmacy, University of North Carolina Medical Center, Chapel Hill, NC; Department of Practice Advancement and Clinical Education, University of North Carolina Eshelman School of Pharmacy, Chapel Hill, NC.
⁵ Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC; Division of Oncology, Department of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC. Electronic address: [email protected].

Abstract

Non-clear cell renal cell carcinoma (RCC) is a heterogeneous disease. We report a case of sarcomatoid non-clear cell RCC in a patient with underlying multiple sclerosis (MS) on immunosuppression with a complete pathologic response to pembrolizumab and axitinib. Comprehensive genomic profiling revealed pathogenic mutations in SETD2 and TP53 with high RNA expression levels of immune checkpoint proteins. Our case illustrates the importance of treatment selection based on presence of sarcomatoid features, underlying autoimmune disease, and genomic profiling.

Publication types

Case Reports
Research Support, N.I.H., Extramural

MeSH terms

Antibodies, Monoclonal, Humanized
Axitinib / therapeutic use
Carcinoma, Renal Cell* / drug therapy
Carcinoma, Renal Cell* / genetics
Carcinoma, Renal Cell* / pathology
Humans
Kidney Neoplasms* / drug therapy
Kidney Neoplasms* / genetics
Kidney Neoplasms* / pathology
Multiple Sclerosis*

Substances

Antibodies, Monoclonal, Humanized
ocrelizumab
Axitinib
pembrolizumab

Abstract

Publication types

MeSH terms

Substances

Grants and funding