TARGET THERAPY FOR METASTATIC RENAL CELL CARCINOMA CASE PRESENTATION
Abstract:
It is a case study of female patient aged 69 years known with no significant family history of
malignancies, diagnosed on July 2012 with a 6 th cervical vertebral body voluminous mass, with
adjacent spine compression and soft tissue invasion due to persistent neurological symptoms for a
several weeks ago. She underwent a tumor ablation with C6 vertebrectomy reconstruction with the use
of titan on September 2012. On October 2012 the histopathology and immunohistochemistry report
determined that is was a clear cell renal cell carcinoma. Further investigations continued in the
oncology department. The toraco-abdominal CT scan in January 2013 identified a right renal apical
and 2 right lung apical micronodules and one on the right base. At the time of presentation in our
Department the patient had a bad Performance Status with cachexy, asthenia and a depressive
syndrome that made her non-eligible for cytoreductive surgery. The patient underwent palliative
radiotherapy on the cervical region: 30y in 10 fractions (over 2 weeks). On January 2013 the patient
started first line treatment for mRCC with Bevacizumab and Interferone with partial remission of the
target lesion on follow-up CT scan (June 2015). Second line treatment for metastatic cancer consists of
on TKI (Sunitinib) and was stopped after almost 22 months of stable disease (April 2016). Our patient
started Everolimus (mTOR inhibitor) on Apr 2017 and continues today with a stable disease, good
Performane Status and no pain. Conclusions: Multidisciplinary management is needed for mRCC
patients suffering from bone metastasis. New agents have become available to treat renal cell cancer
(RCC) in recent years, wich increased overall survival with a good Quality of life.
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