{"title":"舒尼替尼、派姆单抗、贝伐单抗、西罗莫司和唑来膦酸联合治疗局部晚期透明细胞肾细胞癌1例","authors":"Mahdi Mehrabi, Mohammadreza Eslami, Mehrdad Payandeh","doi":"","DOIUrl":null,"url":null,"abstract":"<p><p>Locally advanced renal cell carcinoma (RCC) presents significant therapeutic challenges, particularly in resource-limited settings with restricted access to new therapies. This report describes a new exploratory multimodal therapeutic approach for a patient with locally advanced clear cell RCC (ccRCC) with adrenal and lymph node metastases. A 45-year-old woman presented with an incidentally discovered 9-cm mass in the left kidney, which was later diagnosed as grade-2 ccRCC with adrenal and lymph node involvement. After radical nephrectomy, a multimodal treatment regimen consisting of sunitinib, pembrolizumab, bevacizumab, sirolimus, and zoledronic acid was initiated. Following eight cycles of treatment, computed tomography imaging and ultrasound showed considerable tumor shrinkage, with residual mass decreasing from 22 × 42 mm to 22 × 18 mm, which constituted a \"radiologically complete response.\" The patient had compensatory hypertrophy of the contralateral kidney with preserved renal function. This case illustrates the potential efficacy of a novel multimodal treatment strategy combining targeted therapies, immunotherapy, and bone-modifying agents in a resource-limited setting. Further research is needed to validate this approach in larger, diverse patient cohorts.</p>","PeriodicalId":10796,"journal":{"name":"Croatian Medical Journal","volume":"66 4","pages":"299-304"},"PeriodicalIF":2.3000,"publicationDate":"2025-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12424197/pdf/","citationCount":"0","resultStr":"{\"title\":\"Multimodal treatment approach with sunitinib, pembrolizumab, bevacizumab, sirolimus, and zoledronic acid for locally advanced clear cell renal cell carcinoma: a case report.\",\"authors\":\"Mahdi Mehrabi, Mohammadreza Eslami, Mehrdad Payandeh\",\"doi\":\"\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><p>Locally advanced renal cell carcinoma (RCC) presents significant therapeutic challenges, particularly in resource-limited settings with restricted access to new therapies. This report describes a new exploratory multimodal therapeutic approach for a patient with locally advanced clear cell RCC (ccRCC) with adrenal and lymph node metastases. A 45-year-old woman presented with an incidentally discovered 9-cm mass in the left kidney, which was later diagnosed as grade-2 ccRCC with adrenal and lymph node involvement. After radical nephrectomy, a multimodal treatment regimen consisting of sunitinib, pembrolizumab, bevacizumab, sirolimus, and zoledronic acid was initiated. Following eight cycles of treatment, computed tomography imaging and ultrasound showed considerable tumor shrinkage, with residual mass decreasing from 22 × 42 mm to 22 × 18 mm, which constituted a \\\"radiologically complete response.\\\" The patient had compensatory hypertrophy of the contralateral kidney with preserved renal function. This case illustrates the potential efficacy of a novel multimodal treatment strategy combining targeted therapies, immunotherapy, and bone-modifying agents in a resource-limited setting. Further research is needed to validate this approach in larger, diverse patient cohorts.</p>\",\"PeriodicalId\":10796,\"journal\":{\"name\":\"Croatian Medical Journal\",\"volume\":\"66 4\",\"pages\":\"299-304\"},\"PeriodicalIF\":2.3000,\"publicationDate\":\"2025-08-31\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12424197/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Croatian Medical Journal\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"MEDICINE, GENERAL & INTERNAL\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Croatian Medical Journal","FirstCategoryId":"3","ListUrlMain":"","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"MEDICINE, GENERAL & INTERNAL","Score":null,"Total":0}
Multimodal treatment approach with sunitinib, pembrolizumab, bevacizumab, sirolimus, and zoledronic acid for locally advanced clear cell renal cell carcinoma: a case report.
Locally advanced renal cell carcinoma (RCC) presents significant therapeutic challenges, particularly in resource-limited settings with restricted access to new therapies. This report describes a new exploratory multimodal therapeutic approach for a patient with locally advanced clear cell RCC (ccRCC) with adrenal and lymph node metastases. A 45-year-old woman presented with an incidentally discovered 9-cm mass in the left kidney, which was later diagnosed as grade-2 ccRCC with adrenal and lymph node involvement. After radical nephrectomy, a multimodal treatment regimen consisting of sunitinib, pembrolizumab, bevacizumab, sirolimus, and zoledronic acid was initiated. Following eight cycles of treatment, computed tomography imaging and ultrasound showed considerable tumor shrinkage, with residual mass decreasing from 22 × 42 mm to 22 × 18 mm, which constituted a "radiologically complete response." The patient had compensatory hypertrophy of the contralateral kidney with preserved renal function. This case illustrates the potential efficacy of a novel multimodal treatment strategy combining targeted therapies, immunotherapy, and bone-modifying agents in a resource-limited setting. Further research is needed to validate this approach in larger, diverse patient cohorts.
期刊介绍:
Croatian Medical Journal (CMJ) is an international peer reviewed journal open to scientists from all fields of biomedicine and health related research.
Although CMJ welcomes all contributions that increase and expand on medical knowledge, the two areas are of the special interest: topics globally relevant for biomedicine and health and medicine in developing and emerging countries.