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PD-L1 pathway as a novel target in carcinosarcoma of the kidney and renal pelvis
Ashwin M Raghavan1, Zane C Giffen1, Patrick M Irwin1
1University of Toledo Department of Urology and Renal Transplantation, Toledo, OH, United States.
Abstract:
Carcinosarcoma of the kidney and renal pelvis (CSKP) is a rare and highly-aggressive malignancy characterized by rapid progression and widespread metastases. To date, few studies describe the natural history of the disease. We present a patient placed on pembrolizumab therapy for suspected metastatic colon cancer. The patient was found to have a right renal mass with caval extension on surveillance and ultimately underwent radical surgery revealing carcinosarcoma with positive PD-L1 expression with no evidence of recurrence to date. To our knowledge, this is the first case describing PD-L1 expression in CSKP and presents a novel pathway for future treatment algorithms.
Insights
Carcinosarcoma of the kidney and renal pelvis (CSKP) is a rare cancer. This case study highlights a patient with CSKP showing positive PD-L1 expression, suggesting a new treatment approach.
Area of Science:
- Oncology
- Pathology
Background:
- Carcinosarcoma of the kidney and renal pelvis (CSKP) is a rare, aggressive malignancy with limited data on its natural history.
- Effective treatment strategies for CSKP remain challenging due to its rarity and aggressive nature.
Observation:
- A patient initially treated for suspected metastatic colon cancer was found to have a right renal mass with caval extension.
- The patient underwent radical surgery, which revealed carcinosarcoma of the kidney and renal pelvis.
Findings:
- The resected CSKP specimen demonstrated positive PD-L1 expression.
- The patient has shown no evidence of recurrence to date following surgery.
Implications:
- This is the first reported case of PD-L1 expression in CSKP.
- The presence of PD-L1 suggests potential efficacy of immunotherapy, like pembrolizumab, offering a novel therapeutic avenue for CSKP.
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