Renal-cell carcinoma is frequently associated with tumor thrombus at initial diagnosis. The tumor thrombus is associated with a pejorative survival prognosis. Targeted molecular therapies such as sunitinib have a modest impact on size and level of tumor thrombus. Actually, nivolumab plus ipilimumab combination is the new standard of care as first line for metastatic renal carcinoma. We reported a case of an 87-year old man with a metastatic renal-cell carcinoma and a tumor thrombus level IV. The patient was treated with nivolumab as first line. After seven months of treatment, there was a partial regression of the tumor thrombus size without impact of the tumor thrombus level. To our knowledge, we reported for the first time the positive impact of checkpoint inhibitor on tumor thrombus size in a case of metastatic renal-cell carcinoma with an extensive tumor thrombus.
Laura Bender, Justine Gantzer, Jean Caudrelier, François Somme, Jean Emmanuel Kurtz and Philippe Barthélémy