Immunotherapy beyond progression in advanced renal cell carcinoma: a case report and review of the literature

Immunotherapy. 2018 Sep;10(13):1123-1132. doi: 10.2217/imt-2018-0042.

Abstract

Immunotherapy is associated with different response patterns compared with chemotherapy and targeted therapy, including delayed response and stabilization after progression (pseudoprogression). According to new immuno-based response criteria, immunotherapy can be continued after radiological progression when a clinical benefit is observed. We report a case of an advanced renal cell carcinoma patient treated with nivolumab, who developed clinical benefit and delayed radiological response after initial progression. We performed a review of the literature on immunotherapy beyond progression in advanced solid tumors. 12 clinical trials were identified and showed that selected patients have subsequent response and survival benefit receiving immunotherapy beyond progression. Future studies are needed to optimize timing and duration of immunotherapy and to define patient selection criteria for treatment beyond progression.

Keywords: immune-checkpoint inhibitors; immune-related unconfirmed progressive disease; immunotherapy; pseudoprogression; renal cell carcinoma; treatment beyond progression.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Antineoplastic Agents / therapeutic use*
  • Carcinoma, Renal Cell / immunology
  • Carcinoma, Renal Cell / mortality
  • Carcinoma, Renal Cell / therapy*
  • Clinical Trials as Topic
  • Disease Progression
  • Disease-Free Survival
  • Humans
  • Immunotherapy / methods*
  • Kidney Neoplasms / immunology
  • Kidney Neoplasms / mortality
  • Kidney Neoplasms / therapy*
  • Male
  • Medication Adherence
  • Middle Aged
  • Neoplasm Metastasis
  • Neoplasm Staging
  • Nivolumab / therapeutic use*
  • Patient Selection
  • Programmed Cell Death 1 Receptor / antagonists & inhibitors*
  • Tomography, X-Ray Computed
  • Treatment Outcome

Substances

  • Antineoplastic Agents
  • PDCD1 protein, human
  • Programmed Cell Death 1 Receptor
  • Nivolumab