1. Cytoreductive Nephrectomy Promoted Abscopal Effect of Camrelizumab Combined With Radiotherapy for Metastatic Renal Cell Carcinoma: A Case Report and Review of the Literature.
- Author
-
Wu M, Liu J, Seery S, Meng X, and Yue J
- Subjects
- Aged, Carcinoma, Renal Cell immunology, Carcinoma, Renal Cell pathology, Combined Modality Therapy, Humans, Immune Checkpoint Inhibitors therapeutic use, Kidney Neoplasms immunology, Kidney Neoplasms pathology, Lymphocyte Culture Test, Mixed, Male, Neoplasm Metastasis, Radiotherapy Dosage, Receptors, Antigen, T-Cell, alpha-beta physiology, Tumor-Associated Macrophages immunology, Antibodies, Monoclonal, Humanized therapeutic use, Carcinoma, Renal Cell therapy, Cytoreduction Surgical Procedures methods, Kidney Neoplasms therapy, Nephrectomy methods
- Abstract
There is little evidence around Camrelizumab combined with cytoreductive nephrectomy (CN) and radiotherapy (RT) as a treatment option for metastatic renal cell carcinoma (mRCC). The influence of CN on immune responses and the abscopal effect are not well understood. In this paper, we report a case of anti-programmed cell death-1 (PD-1) treated with combined RT once CN reduced the primary tumor burden (TB). This patient also encountered an increased response to targeted radiotherapy after immune resistance. We also observed a macrophage-to-lymphocyte ratio (MLR) peak, which may be correlated with subsequent pseudoprogression after thoracic radiotherapy. Consequently, even with the disease, this patient has remained stable. This peculiar instance suggests there is a need to investigate the underlying mechanisms of CN in promoting the abscopal effect during immunotherapy when combined with RT. It also suggests that there is a need for further investigation into the role of RT in overcoming immune resistance, and the value of MLR in predicting pseudoprogression. We hypothesize that a heavy tumor burden might suppress the abscopal effect, thereby ensuring that CN promotes it. However, radiotherapy may overcome immune resistance during oligoprogression., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2021 Wu, Liu, Seery, Meng and Yue.)
- Published
- 2021
- Full Text
- View/download PDF