Pathological Complete Response to Pembrolizumab plus Axitinib Combination following Serious Immune-Related Adverse Events in an Advanced Renal Cell Carcinoma Patient with a History of Rheumatoid Arthritis

Autor: Marco Bergamini, Alberto Dalla Volta, Francesca Valcamonico, Irene Caramella, Martina Buffoni, Enrico Munari, Simona Fisogni, Tiziano Zanotelli, Nazareno Roberto Suardi, Alfredo Berruti
Jazyk: angličtina
Rok vydání: 2024
Předmět:
Zdroj: Case Reports in Oncology, Vol 17, Iss 1, Pp 56-68 (2024)
Druh dokumentu: article
ISSN: 1662-6575
00053546
DOI: 10.1159/000535460
Popis: Immune checkpoint inhibitors (ICIs)-based combinations have improved survival outcomes of advanced renal cell carcinoma (RCC) patients and are currently recommended as first-line treatment options. Rheumatoid arthritis (RA) is a systemic autoimmune disease (AD) of unknown etiology characterized by a chronic inflammatory process involving joints and extra-articular organs. Patients with AD are usually excluded from large randomized clinical trials investigating immunotherapeutic drugs. Therefore, little is known about clinical outcomes of patients with a history of RA treated with ICIs in real-world practice. In the present study, we report the clinical outcome of an advanced RCC patient with a history of RA treated with pembrolizumab in combination with axitinib. The patient experienced serious immune-related adverse events (irAEs) and achieved pathological complete response following only one ICI administration. Our case report shows that ICI-based combinations can be administered efficaciously in advanced RCC patients with a history of AD. However, a close monitoring of these patients is required, given the risk of irAEs and clinical exacerbations of symptoms associated with the preexisting AD. Moreover, prospective clinical data are needed to assess the hypothesis of a correlation between the onset of irAEs and AD flares and responses and survival outcomes to ICIs.
Databáze: Directory of Open Access Journals
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