Abstract
A 67-year-old man presented with a 142-mm right renal tumor with multiple lung metastases. Duodenum and ascending colon invasion were also suspected. Performance status did not permit surgical procedure at first visit. We started systemic therapy with a molecular targeted drug. Based on his prognostic risk factors, administration of temsirolimus was initiated, and his performance status improved enough to perform radical right nephrectomy with intestinal resection. Pathology confirmed clear cell renal cell carcinoma, pT4, with duodenum and ascending colon invasion. After surgery, temsirolimus administration was resumed. Eight and a half months after surgery, the patient developed progressive disease, and temsirolimus therapy was discontinued. As a second-line molecular targeted drug, axitinib was employed. Four and a half months after starting axitinib, the patient once again developed progressive disease, and we increased the dosage of axitinib. Currently, at 22 months after surgery, he is alive under axitinib treatment.
This is a preview of subscription content, log in via an institution to check access.
References
Flanigan RC, Mickisch G, Sylvester R et al (2004) Cytoreductive nephrectomy in patients with metastatic renal cancer: a combined analysis. J Urol 171:1071–1076
Flanigan RC, Salmon SE, Blumenstein BA et al (2001) Nephrectomy followed by interferon alfa-2b compared with interferon alfa-2b alone for metastatic renal-cell cancer. N Engl J Med 345:1655–1659
Mickisch GH, Garin A, van Poppel H et al (2001) Radical nephrectomy plus interferon-alfa-based immunotherapy compared with interferon alfa alone in metastatic renal-cell carcinoma: a randomised trial. Lancet 358:966–970
Motzer RJ, Mazumdar M, Bacik J et al (1999) Survival and prognostic stratification of 670 patients with advanced renal cell carcinoma. J Clin Oncol 17:2530–2540
Motzer RL, Agarwal N, Beard C et al (2009) NCCN clinical practice guidelines in oncology: kidney cancer. J Nati Compr Canc Netw 7:618–630
Hudes G, Carducci M, Tomczak P et al (2007) Temsirolimus, interferon alfa, or both for advanced renal-cell carcinoma. N Engl J Med 356:2271–2281
Choueiri TK, Xie W, Kollmannsberger C et al (2011) The impact of cytoreductive nephrectomy on survival of patients with metastatic renal cell carcinoma receiving vascular endothelial growth factor targeted therapy. J Urol 185:60–66
Heng DY, Kollmannsberger C, Chi KN (2010) Targeted therapy for metastatic renal cell carcinoma: current treatment and future directions. Ther Adv Med Oncol 2:39–49
Fishman MN (2013) Targeted therapy of kidney cancer: keeping the art around the algorithms. Cancer Control 20:222–232
Pal SK, Malangone E, Bhurke S, et al (2013) Real-world treatment patterns in third-line patients with metastatic renal cell carcinoma (mRCC): the challenging landscape in the United States. J Clin Oncol 31: suppl 6: abstr 390
Rini BI, Escudier B, Tomczak P et al (2011) Comparative effectiveness of axitinib versus sorafenib in advanced renal cell carcinoma (AXIS): a randomised phase 3 trial. Lancet 378:1931–1939
Coriat R, Ropert S, Mir O et al (2011) Pneumatosis intestinalis associated with treatment of cancer patients with vascular growth factor receptor tyrosine kinase inhibitors sorafenib and sunitinib. Invest New Drugs 29:1090–1093
Acknowledgments
The authors would like to thank Elizabeth Kiritani for English language assistance with the preparation of this report.
Conflict of interest
The authors declare that they have no conflict of interest.
Author information
Authors and Affiliations
Corresponding author
About this article
Cite this article
Yagisawa, T., Kondo, T., Omae, K. et al. Combination of molecular targeted therapy and surgery for a patient with metastatic renal cell carcinoma with a poor prognosis. Int Canc Conf J 4, 138–142 (2015). https://doi.org/10.1007/s13691-014-0185-3
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s13691-014-0185-3