A rapid and systemic complete response to stereotactic body radiation therapy and pembrolizumab in a patient with metastatic renal cell carcinoma

Cancer Biol Ther. 2017 Aug 3;18(8):547-551. doi: 10.1080/15384047.2017.1345389. Epub 2017 Jun 30.

Abstract

Stereotactic body radiation therapy (SBRT) of local tumor would induce an abscopal effect that has been observed in several kinds of human cancers; one important mechanism may involve the improved activation of the host immune system. The immune checkpoint inhibitor can overcome immune tolerance and enhance the activation of antitumor T cells. The combined treatment of SBRT and checkpoint inhibitor may represent a new promising therapeutic approach. Herein, we reported a patient with metastatic renal cell carcinoma (RCC) treated with concurrent SBRT and anti-PD-1 antibody, pembrolizumab, by which the patient achieved an amazingly systemic complete response in only 2.2 months after starting treatment. This case report indicates that the advanced RCC may benefit from the combining treatment of local SBRT and PD-1 inhibitor and provide a useful paradigm worthy of establishing a clinical trial for patients with advanced renal cell carcinoma.

Keywords: Programmed death-1; radiation therapy; renal cell carcinoma.

Publication types

  • Case Reports

MeSH terms

  • Antibodies, Monoclonal, Humanized / therapeutic use*
  • Biomarkers, Tumor / blood
  • Carcinoma, Renal Cell / blood
  • Carcinoma, Renal Cell / diagnostic imaging
  • Carcinoma, Renal Cell / pathology
  • Carcinoma, Renal Cell / therapy*
  • Chemoradiotherapy, Adjuvant / methods
  • Circulating Tumor DNA / blood
  • Combined Modality Therapy
  • Humans
  • Indoles / therapeutic use
  • Kidney / pathology
  • Kidney / surgery
  • Kidney Neoplasms / blood
  • Kidney Neoplasms / diagnostic imaging
  • Kidney Neoplasms / pathology
  • Kidney Neoplasms / therapy*
  • Lymph Nodes / diagnostic imaging
  • Lymph Nodes / pathology*
  • Lymphatic Metastasis
  • Male
  • Mediastinum
  • Middle Aged
  • Nephrectomy
  • Programmed Cell Death 1 Receptor / antagonists & inhibitors
  • Pyrroles / therapeutic use
  • Radiosurgery*
  • Sunitinib
  • Tomography, X-Ray Computed
  • Treatment Outcome

Substances

  • Antibodies, Monoclonal, Humanized
  • Biomarkers, Tumor
  • Circulating Tumor DNA
  • Indoles
  • PDCD1 protein, human
  • Programmed Cell Death 1 Receptor
  • Pyrroles
  • pembrolizumab
  • Sunitinib