Pathological Complete Response to Preoperative Nivolumab Plus Cabozantinib for Renal Cell Carcinoma With Inferior Vena Cava Thrombus: A Case Report.

Surgical treatment of renal cell carcinoma (RCC) with inferior vena cava (IVC) thrombus is associated with high morbidity and mortality rates, therefore presurgical systemic therapies are required in order to improve the safety and feasibility of the surgical procedure by decreasing the thrombus level and burden. The efficacy of presurgical combination therapy of immune checkpoint inhibitors (ICI) and tyrosine kinase inhibitors (TKI) for advanced renal cell carcinoma with IVC thrombus remains unclear.

We report a case of a 69-year-old male with cT3bN0M0 locally advanced RCC. We successfully performed a less invasive nephrectomy with thrombectomy, because nivolumab plus cabozantinib administration remarkably reduced the primary tumor and IVC thrombus, resulting in complete pathological response, as assessed with perioperative immunohistochemistry.

To the best of our knowledge, this is the first report showing that nephrectomy could be safely performed for RCC with IVC thrombus after presurgical nivolumab plus cabozantinib therapy, leading to pathological complete response.

Cancer diagnosis & prognosis. 2023 Jan 03*** epublish ***

Arisa Machida, Daiki Ikarashi, Naoki Yanagawa, Masamichi Suzuki, Tatsuya Kawamura, Kie Sekiguchi, Kenta Takahashi, Renpei Kato, Tomohiko Matsura, Shigekatsu Maekawa, Mitsugu Kanehira, Ryo Takata, Tamotsu Sugai, Wataru Obara

Department of Urology, School of Medicine, Iwate Medical University, Iwate, Japan., Department of Pathology, School of Medicine, Iwate Medical University, Iwate, Japan.