Impressive and durable response to nivolumab in a patient with metastatic type 2 papillary renal cell carcinoma: On-label but without evidence

Diego A. Adrianzen Herrera, Sarah B. Fleisig, Benjamin A. Gartrell

Research output: Contribution to journalArticle

6 Citations (Scopus)

Abstract

Summary: Nivolumab is a treatment option for patients with metastatic renal cell carcinoma (RCC) previously treated with targeted antiangiogenic therapy. Papillary renal cell carcinoma (PRCC) comprises 10–15% of RCC cases but non-clear cell subtypes were excluded from the immunotherapy trials. We report the case of a woman with recurrent metastatic PRCC who had an impressive therapeutic response to nivolumab with no significant adverse events. She had previously been treated with sunitinib and pazopanib with no response. She showed a remarkable clinical improvement after only the first 2 immunotherapy cycles and subsequent radiographic studies demonstrated a marked decrease in tumor burden. At present, she continues to show a durable benefit after 8 months of treatment. Her tumor had <1% positivity for PD-L1 staining and a low tumor mutational burden with no actionable mutations on genomic sequencing. Considering its high genetic variation, checkpoint blockade immunotherapies (CBIs) are attractive treatment options in PRCC. This is the third case that reports objective responses of nivolumab in PRCC. We believe our patient’s experience supports the inclusion of non-clear cell RCC on clinical trials using CBIs. PD-L1 status and TMB may not serve as predictive biomarkers for response.

Original languageEnglish (US)
Pages (from-to)1-4
Number of pages4
JournalInvestigational New Drugs
DOIs
StateAccepted/In press - May 2 2017

Fingerprint

Renal Cell Carcinoma
Immunotherapy
Tumor Burden
Therapeutics
nivolumab
Biomarkers
Clinical Trials
Staining and Labeling
Mutation
Neoplasms

Keywords

  • Immunotherapy
  • Nivolumab
  • Papillary renal cell carcinoma

ASJC Scopus subject areas

  • Oncology
  • Pharmacology
  • Pharmacology (medical)

Cite this

@article{5ed3cebbbaec4cdda8e205b891c443f3,
title = "Impressive and durable response to nivolumab in a patient with metastatic type 2 papillary renal cell carcinoma: On-label but without evidence",
abstract = "Summary: Nivolumab is a treatment option for patients with metastatic renal cell carcinoma (RCC) previously treated with targeted antiangiogenic therapy. Papillary renal cell carcinoma (PRCC) comprises 10–15{\%} of RCC cases but non-clear cell subtypes were excluded from the immunotherapy trials. We report the case of a woman with recurrent metastatic PRCC who had an impressive therapeutic response to nivolumab with no significant adverse events. She had previously been treated with sunitinib and pazopanib with no response. She showed a remarkable clinical improvement after only the first 2 immunotherapy cycles and subsequent radiographic studies demonstrated a marked decrease in tumor burden. At present, she continues to show a durable benefit after 8 months of treatment. Her tumor had <1{\%} positivity for PD-L1 staining and a low tumor mutational burden with no actionable mutations on genomic sequencing. Considering its high genetic variation, checkpoint blockade immunotherapies (CBIs) are attractive treatment options in PRCC. This is the third case that reports objective responses of nivolumab in PRCC. We believe our patient’s experience supports the inclusion of non-clear cell RCC on clinical trials using CBIs. PD-L1 status and TMB may not serve as predictive biomarkers for response.",
keywords = "Immunotherapy, Nivolumab, Papillary renal cell carcinoma",
author = "{Adrianzen Herrera}, {Diego A.} and Fleisig, {Sarah B.} and Gartrell, {Benjamin A.}",
year = "2017",
month = "5",
day = "2",
doi = "10.1007/s10637-017-0469-5",
language = "English (US)",
pages = "1--4",
journal = "Investigational New Drugs",
issn = "0167-6997",
publisher = "Kluwer Academic Publishers",

}

TY - JOUR

T1 - Impressive and durable response to nivolumab in a patient with metastatic type 2 papillary renal cell carcinoma

T2 - On-label but without evidence

AU - Adrianzen Herrera, Diego A.

AU - Fleisig, Sarah B.

AU - Gartrell, Benjamin A.

PY - 2017/5/2

Y1 - 2017/5/2

N2 - Summary: Nivolumab is a treatment option for patients with metastatic renal cell carcinoma (RCC) previously treated with targeted antiangiogenic therapy. Papillary renal cell carcinoma (PRCC) comprises 10–15% of RCC cases but non-clear cell subtypes were excluded from the immunotherapy trials. We report the case of a woman with recurrent metastatic PRCC who had an impressive therapeutic response to nivolumab with no significant adverse events. She had previously been treated with sunitinib and pazopanib with no response. She showed a remarkable clinical improvement after only the first 2 immunotherapy cycles and subsequent radiographic studies demonstrated a marked decrease in tumor burden. At present, she continues to show a durable benefit after 8 months of treatment. Her tumor had <1% positivity for PD-L1 staining and a low tumor mutational burden with no actionable mutations on genomic sequencing. Considering its high genetic variation, checkpoint blockade immunotherapies (CBIs) are attractive treatment options in PRCC. This is the third case that reports objective responses of nivolumab in PRCC. We believe our patient’s experience supports the inclusion of non-clear cell RCC on clinical trials using CBIs. PD-L1 status and TMB may not serve as predictive biomarkers for response.

AB - Summary: Nivolumab is a treatment option for patients with metastatic renal cell carcinoma (RCC) previously treated with targeted antiangiogenic therapy. Papillary renal cell carcinoma (PRCC) comprises 10–15% of RCC cases but non-clear cell subtypes were excluded from the immunotherapy trials. We report the case of a woman with recurrent metastatic PRCC who had an impressive therapeutic response to nivolumab with no significant adverse events. She had previously been treated with sunitinib and pazopanib with no response. She showed a remarkable clinical improvement after only the first 2 immunotherapy cycles and subsequent radiographic studies demonstrated a marked decrease in tumor burden. At present, she continues to show a durable benefit after 8 months of treatment. Her tumor had <1% positivity for PD-L1 staining and a low tumor mutational burden with no actionable mutations on genomic sequencing. Considering its high genetic variation, checkpoint blockade immunotherapies (CBIs) are attractive treatment options in PRCC. This is the third case that reports objective responses of nivolumab in PRCC. We believe our patient’s experience supports the inclusion of non-clear cell RCC on clinical trials using CBIs. PD-L1 status and TMB may not serve as predictive biomarkers for response.

KW - Immunotherapy

KW - Nivolumab

KW - Papillary renal cell carcinoma

UR - http://www.scopus.com/inward/record.url?scp=85018371391&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85018371391&partnerID=8YFLogxK

U2 - 10.1007/s10637-017-0469-5

DO - 10.1007/s10637-017-0469-5

M3 - Article

C2 - 28466375

AN - SCOPUS:85018371391

SP - 1

EP - 4

JO - Investigational New Drugs

JF - Investigational New Drugs

SN - 0167-6997

ER -