Background:

Papillary renal cell carcinoma (pRCC) represents the second most common histologic subtype of renal cell carcinoma and comprises 2 subtypes. Prognosis for type 2 is associated with poor clinical outcome. Current guidelines are based on phase II trials, phase III trials in patients with clear cell histology, or retrospective data.

Case description:

To our knowledge, we describe for the first time a case of a patient with heavily pretreated metastatic pRCC who benefited from the combination of lenvatinib plus everolimus for more than 2 years.

Conclusion:

According to immunohistologic and biological findings in our patient both on primary tumor and liver metastasis, we hypothesize that selected patients with metastatic pRCC, progressed to standard/available treatments (including angiogenic drugs, mTOR inhibitors, and immunotherapy) and dissociated response to everolimus, could benefit from adding lenvatinib to everolimus.

中文翻译：

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乐伐替尼联合依维莫司在经过大量预处理的乳头状肾细胞癌患者中的活性：病例报告。

背景：

乳头状肾细胞癌 (pRCC) 是肾细胞癌中第二常见的组织学亚型，包括 2 个亚型。2 型的预后与较差的临床结果相关。目前的指南基于 II 期试验、透明细胞组织学患者的 III 期试验或回顾性数据。

案例描述：

据我们所知，我们首次描述了一例经过大量预处理的转移性 pRCC 患者，该患者受益于乐伐替尼联合依维莫司超过 2 年。

结论：

根据我们患者在原发性肿瘤和肝转移方面的免疫组织学和生物学发现，我们假设选定的转移性 pRCC 患者进展为标准/可用治疗（包括血管生成药物、mTOR 抑制剂和免疫治疗）和对依维莫司的解离反应，可以从依维莫司中加入乐伐替尼获益。