title: Long-term Response to Nivolumab and Acute Renal Failure in a Patient with Metastatic Papillary Renal Cell Carcinoma and a PD-L1 Tumor Expression Increased with Sunitinib Therapy: A Case Report.
abstract: BACKGROUND
  Papillary renal cell carcinoma (PRCC), which represents around 20% of renal cell carcinomas, is a heterogeneous disease that includes different tumor types with several clinical and molecular phenotypes. Nivolumab, a fully human IgG4 programed cell death protein 1 immune checkpoint inhibitor antibody, has shown not only an overall survival advantage when compared to everolimus but also a relatively good side-effect profile among patients with previously treated advanced or metastatic renal cell carcinoma.
  
  
  METHODS
  We describe a case of a young man diagnosed with PRCC that achieved a durable response to nivolumab despite a temporary suspension of the treatment due to a renal function side effect. To the best of our knowledge, it is the first renal failure secondary to nivolumab in a metastatic renal cell carcinoma patient.
  
  
  CONCLUSIONS
  Nivolumab is a promising drug in patients with metastatic PRCC and long-term responses can be achieved. In case of acute renal failure secondary to this treatment, temporary therapy suspension and a low dose of systemic corticosteroids can recover renal function without a negative impact on treatment efficacy.
authors.affiliation: Servizo de Oncoloxía Médica & Grupo de Oncoloxía Médica Traslacional, Instituto de Investigación Sanitaria de Santiago de Compostela (IDIS), Complexo Hospitalario Universitario de Santiago de Compostela , A Coruña , Spain.
authors.forename: Juan
authors.initials: J
authors.lastname: Ruiz-Bañobre
authors.affiliation: Servizo de Oncoloxía Médica & Grupo de Oncoloxía Médica Traslacional, Instituto de Investigación Sanitaria de Santiago de Compostela (IDIS), Complexo Hospitalario Universitario de Santiago de Compostela , A Coruña , Spain.
authors.forename: Urbano
authors.initials: U
authors.lastname: Anido
authors.affiliation: Servizo de Anatomía Patolóxica, Instituto de Investigación Sanitaria de Santiago de Compostela (IDIS), Complexo Hospitalario Universitario de Santiago de Compostela , A Coruña , Spain.
authors.forename: Ihab
authors.initials: I
authors.lastname: Abdulkader
authors.affiliation: Servizo de Anatomía Patolóxica, Instituto de Investigación Sanitaria de Santiago de Compostela (IDIS), Complexo Hospitalario Universitario de Santiago de Compostela , A Coruña , Spain.
authors.forename: José
authors.initials: J
authors.lastname: Antúnez-López
authors.affiliation: Servizo de Oncoloxía Médica & Grupo de Oncoloxía Médica Traslacional, Instituto de Investigación Sanitaria de Santiago de Compostela (IDIS), Complexo Hospitalario Universitario de Santiago de Compostela , A Coruña , Spain.
authors.forename: Rafael
authors.initials: R
authors.lastname: López-López
authors.affiliation: Servizo de Oncoloxía Médica & Grupo de Oncoloxía Médica Traslacional, Instituto de Investigación Sanitaria de Santiago de Compostela (IDIS), Complexo Hospitalario Universitario de Santiago de Compostela , A Coruña , Spain.
authors.forename: Jorge
authors.initials: J
authors.lastname: García-González
keywords: immunotherapy; long-term response; nivolumab; papillary renal cell carcinoma; programed death-ligand 1; renal cell carcinoma; sunitinib; vascular normalization