Efficacy of cabozantinib therapy for brain metastases from renal cell carcinoma

Abstract

Introduction We report two cases of renal cell carcinoma with brain metastases that showed remarkable responses to cabozantinib. Case presentation (Case 1) A 70‐year‐old man with cT3aN0M0 clear cell renal cell carcinoma underwent radical nephrectomy and developed multiple brain metastases 2 months postoperatively. The brain lesions regressed after stereotactic radiotherapy followed by ipilimumab plus nivolumab therapy, but a new brain metastasis that caused hemiplegia developed after 6 months and showed no response to stereotactic radiotherapy. However, complete remission was achieved, and hemiplegia ceased within 2 weeks of cabozantinib therapy. (Case 2) A 63‐year‐old man with cT3aN0M1 clear cell renal cell carcinoma and brain metastases underwent upfront cytoreductive nephrectomy. The brain lesions progressed rapidly 1 month postoperatively. The lesions disappeared 2 weeks after cabozantinib plus nivolumab therapy. Conclusion Cabozantinib, alone or in combination with immune checkpoint inhibitors, may be a viable option for clear cell renal cell carcinoma with brain metastases.

Keywords

• brain metastases
• cabozantinib
• clear cell renal cell carcinoma
• immunotherapy
• radiotherapy