A case of metastatic renal cell carcinoma successfully treated with deferred cytoreductive nephrectomy following lenvatinib plus pembrolizumab combination therapy.

Combination therapy using immuno-oncology drugs with tyrosine kinase inhibitors is increasingly important in the therapeutic strategy for metastatic renal cell carcinomas. Here, we report a case of metastatic renal cell carcinoma that was successfully treated with deferred cytoreductive nephrectomy following lenvatinib plus pembrolizumab combination therapy.

A 49-year-old man was referred to our hospital with a diagnosis of advanced right kidney cancer with multiple lung metastases (cT3aN0M1). The size of the primary tumor was so huge that it exceeded 20 cm in diameter, pushing the liver and intestines to the left. After administration of lenvatinib and pembrolizumab combination as first-line treatment, all the metastatic lung lesions disappeared, and the primary lesion shrank significantly. Robot-assisted radical nephrectomy was successfully performed, resulting in complete surgical remission.

Deferred cytoreductive nephrectomy following a lenvatinib plus pembrolizumab combination is a useful therapeutic strategy for achieving complete remission of metastatic renal cell carcinomas.

IJU case reports. 2023 Mar 19*** epublish ***

Hiroaki Sato, Tomokazu Sazuka, Ayumi Fujimoto, Sakurako Kagitani, Takayuki Arai, Yusuke Goto, Yusuke Imamura, Shinichi Sakamoto, Jun-Ichiro Ikeda, Tomohiko Ichikawa

Department of Urology Chiba University Graduate School of Medicine Chiba Japan., Department of Molecular Pathology Chiba University Graduate School of Medicine Chiba Japan., Department of Diagnostic Pathology Chiba University Graduate School of Medicine Chiba Japan.