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[A CASE OF RENAL CELL CARCINOMA WITH SMALL INTESTINE METASTASIS DURING NIVOLUMAB PLUS IPILIMUMAB].

Yuta Karibe1, Tadashi Tabei1, Hiroyuki Hayashi2

  • 1Department of Urology, Yokohama Municipal Citizen's Hospital.

Nihon Hinyokika Gakkai Zasshi. the Japanese Journal of Urology
|July 19, 2023
PubMed
Summary

This study details a patient with metastatic kidney cancer treated with nivolumab and ipilimumab. Despite initial response and symptom improvement, the patient experienced immune-related adverse events and intussusception, requiring surgical intervention.

Keywords:
nivolumab plus ipilimumabrenal cell carcinomasmall intestine metastasis

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Area of Science:

  • Oncology
  • Immunotherapy
  • Nephrology

Context:

  • A 71-year-old male presented with hoarseness and upper extremity numbness, later diagnosed with advanced renal clear cell carcinoma with lung metastases.
  • The patient had a poor-risk International Metastatic Renal Cell Carcinoma Database Consortium score, indicating a challenging prognosis.

Purpose:

  • To report a case of advanced renal clear cell carcinoma treated with first-line nivolumab plus ipilimumab.
  • To describe the management of immune-related adverse events and a rare complication of intussusception during immunotherapy.

Summary:

  • Initial treatment with nivolumab and ipilimumab led to significant tumor shrinkage and symptom improvement.
  • The patient developed immune-related adverse events (diarrhea, rash, anemia) and subsequently intestinal intussusception due to metastatic disease, requiring surgical resection.
  • Post-operatively, anemia and elevated C-reactive protein improved, and other metastatic lesions continued to respond to treatment.

Impact:

  • This case highlights the complex management of advanced renal clear cell carcinoma under immunotherapy.
  • It underscores the importance of monitoring for and managing immune-related adverse events and treatment complications.
  • The case demonstrates the potential long-term efficacy of nivolumab plus ipilimumab in select patients with metastatic renal cell carcinoma.