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Updated: Dec 10, 2025

A Syngeneic Mouse Model of Metastatic Renal Cell Carcinoma for Quantitative and Longitudinal Assessment of Preclinical Therapies
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Fatal hyperprogression induced by nivolumab in metastatic renal cell carcinoma with sarcomatoid features: a case

Michele Dionese1, Francesco Pierantoni1, Marco Maruzzo1

  • 1Oncology Unit 1, Department of Oncology, Istituto Oncologico Veneto IOV IRCCS, Padua.

Anti-Cancer Drugs
|September 2, 2020
PubMed

Insights

Immune checkpoint inhibitors (ICIs) like nivolumab treat metastatic renal cell carcinoma (mRCC). However, some patients experience hyperprogression, a rare acceleration of tumor growth, leading to poor outcomes.

Area of Science:

  • Oncology
  • Immunotherapy
  • Renal Cell Carcinoma Research

Background:

  • Nivolumab is a standard treatment for metastatic renal cell carcinoma (mRCC) after antiangiogenic therapy.
  • Biomarkers for predicting ICI response in mRCC are lacking, though certain patient groups (IMDC intermediate-poor risk, sarcomatoid tumors) show better outcomes.
  • Immune checkpoint inhibitors (ICIs) can paradoxically accelerate tumor growth, a phenomenon termed hyperprogression, associated with poor survival.

Observation:

  • A case of mRCC with sarcomatoid features presented with hyperprogression after nivolumab treatment.
  • The patient experienced rapid tumor growth and mortality following nivolumab initiation.
  • Sarcomatoid histology in mRCC may influence differential responses to immunotherapy and antiangiogenic agents.

Findings:

  • Hyperprogression is a rare but severe adverse event associated with ICI therapy in mRCC.
  • The frequency and clinical significance of hyperprogression in mRCC require further investigation.
  • Sarcomatoid features in mRCC might be linked to distinct therapeutic responses and hyperprogression risk.

Implications:

  • Understanding hyperprogression is crucial for optimizing ICI therapy in mRCC.
  • Further research into predictive biomarkers for ICI response and hyperprogression is warranted.
  • The unique biological characteristics of sarcomatoid RCC necessitate tailored treatment strategies and careful monitoring during immunotherapy.

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