Case Report
Copyright ©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Oct 6, 2024; 12(28): 6230-6236
Published online Oct 6, 2024. doi: 10.12998/wjcc.v12.i28.6230
Toripalimab in combination with chemotherapy effectively suppresses local recurrence and metastatic sarcomatoid renal cell carcinoma: A case report
Ming-Zhu Gao, Nian-Fei Wang, Jin-You Wang, Li Ma, Yu-Cai Yang
Ming-Zhu Gao, Nian-Fei Wang, Yu-Cai Yang, Department of Oncology, the Second Affiliated Hospital of Anhui Medical University, Hefei 230601, China
Jin-You Wang, Department of Urology, the Second Affiliated Hospital of Anhui Medical University, Hefei 230601, China
Li Ma, Department of Pathology, the Second Affiliated Hospital of Anhui Medical University, Hefei 230601, China
Co-first authors: Ming-Zhu Gao and Nian-Fei Wang.
Author contributions: Gao MZ and Wang NF carried out the interpretation of the data and drafted the manuscript; Ma L and Yang YC participated in the collection of data and data analysis; Wang JY conceived and designed the study; all authors have read and approved the final manuscript.
Supported by The Health Research Program of Anhui Province, China, No. AHWJ2022b048; The Research Foundation of Anhui Medical University, China, No. 2021xkj164; and The Clinical Scientific Research Cultivation Project of the Second Affiliated Hospital of Anhui Medical University, China, No. 2021LCZD04.
Informed consent statement: All study participants, or their legal guardian, provided informed written consent prior to study enrollment. Written informed consent for publication of their clinical details and clinical images were obtained from the patient.
Conflict-of-interest statement: All authors declare that there are no conflicts of interest that could be perceived as prejudicing the impartiality of the research reported.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Jin-You Wang, MD, Surgeon, Surgical Oncologist, Teacher, Department of Urology, the Second Affiliated Hospital of Anhui Medical University, Furong Road, Hefei 230601, Anhui Province, China. jinyouwang@126.com
Received: June 5, 2024
Revised: July 9, 2024
Accepted: July 17, 2024
Published online: October 6, 2024
Processing time: 69 Days and 2.3 Hours
Abstract
BACKGROUND

Sarcomatoid renal cell carcinoma (SRCC) is a rare variant of renal cell carcinoma associated with an unfavorable prognosis. The efficacy of conventional chemotherapy and targeted therapies are limited, whereas the emergence of immune checkpoint inhibitor has introduced new avenues for managing advanced SRCC.

CASE SUMMARY

A 77-year-old female patient was referred to our hospital following the incidental detection of a right kidney tumor without specific symptoms. The tumor was successfully resected, and subsequent pathological examination confirmed SRCC. She experienced both local recurrence and distant metastasis eight months after the initial laparoscopic resection. Following six cycles of toripalimab combined with pirarubicin chemotherapy, the patient achieved a partial response. Subsequently, the patient attained an almost-complete continuous response to toripalimab monotherapy maintenance for an additional six cycles. She has not experienced disease progression for 15 months, and her overall survival has reached 24 months thus far.

CONCLUSION

Combination therapy with programmed death 1 antibodies and cytotoxic agents may be a recommended first-line treatment approach for SRCC.

Keywords: Renal cell carcinoma, Sarcomatoid dedifferentiation, Immune checkpoint inhibitor, Chemotherapy, Case report

Core Tip: Sarcomatoid renal cell carcinoma (SRCC) is a highly aggressive and uncommon malignant tumor of the kidney, which is associated with a rapid clinical course and unfavorable prognosis compared to conventional RCC. Traditional chemotherapy and targeted therapies have limited efficacy against SRCC. We present a rare case of recurrent and metastatic SRCC that achieved excellent outcomes with the combination of immunotherapy and chemotherapy. This report sheds new light on diagnostic and therapeutic approaches for SRCC.