Efficacy of vertebral cryoablation and immunotherapy in a patient with metastatic renal cell carcinoma: a case report
Abstract Background In metastatic renal cell carcinoma, immunotherapy is the only treatment modality associated with a complete and durable response, but severe toxicity limits its usefulness. If toxicity could be eliminated, immunotherapy might be an effective treatment for metastatic renal cell ca...
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| Format: | Article |
| Language: | English |
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BMC
2019-04-01
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| Series: | Journal of Medical Case Reports |
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| Online Access: | http://link.springer.com/article/10.1186/s13256-019-2049-0 |
| _version_ | 1830428985243205632 |
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| author | Apiruk Sangsin Hideki Murakami Takaki Shimizu Satoshi Kato Hiroyuki Tsuchiya |
| author_facet | Apiruk Sangsin Hideki Murakami Takaki Shimizu Satoshi Kato Hiroyuki Tsuchiya |
| author_sort | Apiruk Sangsin |
| collection | DOAJ |
| description | Abstract Background In metastatic renal cell carcinoma, immunotherapy is the only treatment modality associated with a complete and durable response, but severe toxicity limits its usefulness. If toxicity could be eliminated, immunotherapy might be an effective treatment for metastatic renal cell carcinoma. We present a case of a patient with spinal metastatic renal cell carcinoma treated with total en bloc spondylectomy and reconstruction using a cryo-treated tumor-bearing bone graft; the patient demonstrated an antitumor cryoimmunological response. Case presentation A 51-year-old Japanese man presented with back pain 4 years after undergoing a left-sided total nephrectomy for renal cell carcinoma. He was diagnosed with metastases in the T1–T3 vertebrae, right adrenal gland, sternum, left clavicle, and sacrum. Total en bloc spondylectomy and reconstruction using a cryo-treated tumor-bearing bone graft was performed to treat the vertebral metastases. Sunitinib and then everolimus were also administered. Serum interferon-γ and interleukin 12 levels were measured before surgery and at 1, 3, 6, and 12 months after surgery. Serum interferon-γ and interleukin 12 levels increased 3 months after surgery; this increase was sustained for 6 months. No local recurrence or other distant metastases occurred. The bone metastases remained stable, and the adrenal metastasis progressed slowly. The duration of progression-free survival during sunitinib and everolimus treatment was 24 and 40 months, respectively, and overall survival is currently 5.5 years. Conclusions This report demonstrates that using cryo-treated tumor-bearing tissue in a patient with metastatic renal cell carcinoma stimulated an antitumor cryoimmunological response. |
| first_indexed | 2024-12-21T01:25:41Z |
| format | Article |
| id | doaj.art-e309cc6c6c9f43e68910aeaaa652cb05 |
| institution | Directory Open Access Journal |
| issn | 1752-1947 |
| language | English |
| last_indexed | 2024-12-21T01:25:41Z |
| publishDate | 2019-04-01 |
| publisher | BMC |
| record_format | Article |
| series | Journal of Medical Case Reports |
| spelling | doaj.art-e309cc6c6c9f43e68910aeaaa652cb052022-12-21T19:20:31ZengBMCJournal of Medical Case Reports1752-19472019-04-011311510.1186/s13256-019-2049-0Efficacy of vertebral cryoablation and immunotherapy in a patient with metastatic renal cell carcinoma: a case reportApiruk Sangsin0Hideki Murakami1Takaki Shimizu2Satoshi Kato3Hiroyuki Tsuchiya4Department of Orthopedic Surgery, Graduate School of Medical Sciences, Kanazawa UniversityDepartment of Orthopedic Surgery, Graduate School of Medical Sciences, Kanazawa UniversityDepartment of Orthopedic Surgery, Graduate School of Medical Sciences, Kanazawa UniversityDepartment of Orthopedic Surgery, Graduate School of Medical Sciences, Kanazawa UniversityDepartment of Orthopedic Surgery, Graduate School of Medical Sciences, Kanazawa UniversityAbstract Background In metastatic renal cell carcinoma, immunotherapy is the only treatment modality associated with a complete and durable response, but severe toxicity limits its usefulness. If toxicity could be eliminated, immunotherapy might be an effective treatment for metastatic renal cell carcinoma. We present a case of a patient with spinal metastatic renal cell carcinoma treated with total en bloc spondylectomy and reconstruction using a cryo-treated tumor-bearing bone graft; the patient demonstrated an antitumor cryoimmunological response. Case presentation A 51-year-old Japanese man presented with back pain 4 years after undergoing a left-sided total nephrectomy for renal cell carcinoma. He was diagnosed with metastases in the T1–T3 vertebrae, right adrenal gland, sternum, left clavicle, and sacrum. Total en bloc spondylectomy and reconstruction using a cryo-treated tumor-bearing bone graft was performed to treat the vertebral metastases. Sunitinib and then everolimus were also administered. Serum interferon-γ and interleukin 12 levels were measured before surgery and at 1, 3, 6, and 12 months after surgery. Serum interferon-γ and interleukin 12 levels increased 3 months after surgery; this increase was sustained for 6 months. No local recurrence or other distant metastases occurred. The bone metastases remained stable, and the adrenal metastasis progressed slowly. The duration of progression-free survival during sunitinib and everolimus treatment was 24 and 40 months, respectively, and overall survival is currently 5.5 years. Conclusions This report demonstrates that using cryo-treated tumor-bearing tissue in a patient with metastatic renal cell carcinoma stimulated an antitumor cryoimmunological response.http://link.springer.com/article/10.1186/s13256-019-2049-0Metastatic renal cell carcinomaVertebral cryoablationImmunotherapy |
| spellingShingle | Apiruk Sangsin Hideki Murakami Takaki Shimizu Satoshi Kato Hiroyuki Tsuchiya Efficacy of vertebral cryoablation and immunotherapy in a patient with metastatic renal cell carcinoma: a case report Journal of Medical Case Reports Metastatic renal cell carcinoma Vertebral cryoablation Immunotherapy |
| title | Efficacy of vertebral cryoablation and immunotherapy in a patient with metastatic renal cell carcinoma: a case report |
| title_full | Efficacy of vertebral cryoablation and immunotherapy in a patient with metastatic renal cell carcinoma: a case report |
| title_fullStr | Efficacy of vertebral cryoablation and immunotherapy in a patient with metastatic renal cell carcinoma: a case report |
| title_full_unstemmed | Efficacy of vertebral cryoablation and immunotherapy in a patient with metastatic renal cell carcinoma: a case report |
| title_short | Efficacy of vertebral cryoablation and immunotherapy in a patient with metastatic renal cell carcinoma: a case report |
| title_sort | efficacy of vertebral cryoablation and immunotherapy in a patient with metastatic renal cell carcinoma a case report |
| topic | Metastatic renal cell carcinoma Vertebral cryoablation Immunotherapy |
| url | http://link.springer.com/article/10.1186/s13256-019-2049-0 |
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