Possible abscopal effect after discontinuation of nivolumab in metastatic renal cell carcinoma

Abstract

Introduction Renal cell carcinoma has been considered radioresistant. Recently, several studies have reported the efficacy of combination therapy using radiotherapy and immune checkpoint inhibitors. Case presentation In 1999, a 56‐year‐old woman underwent left nephrectomy (clear cell carcinoma, pT1bN0M0). Seventeen years postoperatively, recurrence in the left lung hilum was observed. Despite administration of three molecular target drugs, all treatments were terminated due to adverse events. Nivolumab was initiated in December 2016. In August 2017, subcutaneous and lung metastases were observed. Moreover in January 2018, right renal metastasis was noted. After 22 cycles of nivolumab treatment, metastasis in the iliac bone was observed, and the patient was subjected to conventional palliative external beam radiation therapy. Five months after radiotherapy, there was significant reduction in multiple metastases. Here, we reported the case presenting with possible abscopal effect. Conclusion Radiotherapy combined with immune checkpoint inhibitors may induce systemic effects against metastatic renal carcinoma.

Keywords

• abscopal effect
• immune checkpoint inhibitor
• programmed cell death‐1
• radiotherapy
• renal cell carcinoma