Cytoreductive Nephrectomy Promoted Abscopal Effect of Camrelizumab Combined With Radiotherapy for Metastatic Renal Cell Carcinoma:A Case Report and Review of the Literature

Wu, M. and Liu, J. and Seery, S. and Meng, X. and Yue, J. (2021) Cytoreductive Nephrectomy Promoted Abscopal Effect of Camrelizumab Combined With Radiotherapy for Metastatic Renal Cell Carcinoma:A Case Report and Review of the Literature. Frontiers in Immunology, 12. ISSN 1664-3224

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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. © Copyright © 2021 Wu, Liu, Seery, Meng and Yue.

Item Type:
Journal Article
Journal or Publication Title:
Frontiers in Immunology
Uncontrolled Keywords:
/dk/atira/pure/subjectarea/asjc/2700/2723
Subjects:
ID Code:
157297
Deposited By:
Deposited On:
21 Jul 2021 16:15
Refereed?:
Yes
Published?:
Published
Last Modified:
06 Oct 2021 08:22