International Cancer Conference Journal

, Volume 8, Issue 1, pp 29–32 | Cite as

Marked response to nivolumab combined with external radiation therapy for metastatic renal cell carcinoma: report of two cases

  • Yuto Matsushita
  • Katsumasa Nakamura
  • Hiroshi Furuse
  • Kenji Ichinohe
  • Hideaki MiyakeEmail author
Case report


Although nivolumab has been regarded as a standard agent for patients with previously treated advanced renal cell carcinoma (RCC), a significant proportion of these patients fail to achieve a response to nivolumab. In recent years, several studies have reported the favorable therapeutic impact of combined therapy with immune checkpoint inhibitors and radiotherapy on a wide variety of advanced malignant tumors, such as melanoma and lung cancer; however, the significance of this combined treatment for advanced RCC patients has not been well characterized. Here, we report two patients with metastatic RCC showing a marked response to nivolumab and external radiation therapy, including one with an abscopal response, after progression on prior treatment with multiple targeted agents. Based on the clinical courses of these two patients suggesting additive or synergistic efficacies on combining radiation with nivolumab, it might be worthwhile to consider the addition of radiotherapy for metastatic RCC patients treated with nivolumab.


Metastatic renal cell carcinoma Nivolumab Radiation Abscopal effect 


Compliance with ethical standards

Conflict of interest

Y. Matsushita, K. Nakamura, H. Furuse, K. Ichinohe and H. Miyake have declared no conflict of interest.


  1. 1.
    Atkins MB, Clark JI, Quinn DI (2017) Immune checkpoint inhibitors in advanced renal cell carcinoma: experience to date and future directions. Ann Oncol 28:1484–1494CrossRefGoogle Scholar
  2. 2.
    Motzer RJ, Escudier B, McDermott DF et al (2015) Nivolumab versus everolimus in advanced renal-cell carcinoma. N Engl J Med 373:1803–1813CrossRefGoogle Scholar
  3. 3.
    Tannir NM, Pal SK, Atkins MB (2018) Second-line treatment landscape for renal cell carcinoma: a comprehensive review. Oncologist 23:540–555CrossRefGoogle Scholar
  4. 4.
    De Giorgi U, Cartenì G, Giannarelli D et al (2018) Safety and efficacy of nivolumab for metastatic renal cell carcinoma: real-world results from an expanded access programme. BJU Int in pressGoogle Scholar
  5. 5.
    Chajon E, Castelli J, Marsiglia H et al (2017) The synergistic effect of radiotherapy and immunotherapy: A promising but not simple partnership. Crit Rev Oncol Hematol 111:124–132CrossRefGoogle Scholar
  6. 6.
    Wang Y, Deng W, Li N et al (2018) Combining Immunotherapy and Radiotherapy for Cancer Treatment: Current Challenges and Future Directions. Front Pharmacol 9:185CrossRefGoogle Scholar
  7. 7.
    Walle T, Martinez Monge R et al (2018) Radiation effects on antitumor immune responses: current perspectives and challenges. Ther Adv Med Oncol 10:1758834017742575CrossRefGoogle Scholar
  8. 8.
    Ko EC, Formenti SC (2018) Radiotherapy and checkpoint inhibitors: a winning new combination? Ther Adv Med Oncol 10:1758835918768240CrossRefGoogle Scholar
  9. 9.
    Koller KM, Mackley HB, Liu J et al (2017) Improved survival and complete response rates in patients with advanced melanoma treated with concurrent ipilimumab and radiotherapy versus ipilimumab alone. Cancer Biol Ther 18:36–42CrossRefGoogle Scholar
  10. 10.
    Fiorica F, Belluomini L, Stefanelli A et al (2018) Immune Checkpoint Inhibitor Nivolumab and Radiotherapy in Pretreated Lung Cancer Patients: Efficacy and Safety of Combination. Am J Clin Oncol in pressGoogle Scholar
  11. 11.
    Hlavata Z, Solinas C, De Silva P et al (2018) The Abscopal Effect in the Era of Cancer Immunotherapy: a Spontaneous Synergism Boosting Anti-tumor Immunity? Target Oncol 13:113–123CrossRefGoogle Scholar
  12. 12.
    Brix N, Tiefenthaller A, Anders H et al (2017) Abscopal, immunological effects of radiotherapy: Narrowing the gap between clinical and preclinical experiences. Immunol Rev 280:249–279CrossRefGoogle Scholar
  13. 13.
    De Meerleer G, Khoo V, Escudier B et al (2014) Radiotherapy for renal-cell carcinoma. Lancet Oncol 15:e170–e177CrossRefGoogle Scholar
  14. 14.
    Xie G, Gu D, Zhang L et al (2017) A rapid and systemic complete response to stereotactic body radiation therapy and pembrolizumab in a patient with metastatic renal cell carcinoma. Cancer Biol Ther 18:547–551CrossRefGoogle Scholar
  15. 15.
    Adashek JJ, Salgia M, Dizman N et al (2018) Concomitant Radioembolization and Immune Checkpoint Inhibition in Metastatic Renal Cell Carcinoma. Case Rep Oncol 11:276–280CrossRefGoogle Scholar
  16. 16.
    Wong AS, Thian YL, Kapur J et al (2018) Pushing the limits of immune-related response: a case of “extreme pseudoprogression”. Cancer Immunol Immunother 67:1105–1111CrossRefGoogle Scholar

Copyright information

© The Japan Society of Clinical Oncology 2018

Authors and Affiliations

  • Yuto Matsushita
    • 1
  • Katsumasa Nakamura
    • 2
  • Hiroshi Furuse
    • 3
  • Kenji Ichinohe
    • 4
  • Hideaki Miyake
    • 1
    Email author
  1. 1.Department of UrologyHamamatsu University School of MedicineHamamatsuJapan
  2. 2.Department of Radiation OncologyHamamatsu University School of MedicineHamamatsuJapan
  3. 3.Department of UrologyChutoen General Medical CenterKakegawaJapan
  4. 4.Department of Radiation OncologyChutoen General Medical CenterKakegawaJapan

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