Successful Combination Therapy With Lenvatinib Plus Pembrolizumab for Rare Case of Advanced Renal Cell Carcinoma With Ocular Adnexal Metastasis.

BACKGROUND

Ocular adnexal (OA) metastasis from renal cell carcinoma (RCC) is a very rare end-stage entity with a poor prognosis. Reported here is a case of metastatic RCC for which combination therapy with lenvatinib plus pembrolizumab was given for OA metastasis and achieved an excellent response.

CASE: A 54-year-old man was referred to our hospital complaining of right eye pain, with a right intraocular tumor showing a maximum diameter of 3 cm subsequently revealed by computed tomography (CT) imaging. Additionally, masses in the right kidney, both lungs, and right iliac bone were noted, while a subsequent percutaneous renal needle biopsy indicated RCC with multiple metastases (cT3aN0M1). Administration of lenvatinib plus pembrolizumab combination therapy was given as first-line treatment, with rapid improvement of the elevated inflammatory response and anemia noted. Findings obtained 17 months following initiation of therapy showed significant shrinkage of the primary and iliac bone lesions, while the OA and lung metastatic lesions had completely disappeared.

CONCLUSION

These results highlight the potential of lenvatinib plus pembrolizumab combination therapy for the treatment of RCC with OA metastasis, which is generally considered to be an end stage for cancer cases.