Rechallenge of carboplatin‑gemcitabine based chemotherapy for rapidly progressing metastatic collecting duct carcinoma of the kidney leading to a delayed and durable complete response: A case report
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- Published online on: January 29, 2019 https://doi.org/10.3892/ol.2019.9991
- Pages: 3576-3580
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Abstract
Renal collecting duct carcinoma (CDC) is a rare and highly aggressive subtype of kidney cancer with poor prognosis. We report a case of one patient, who was successfully treated with gemcitabine‑platin based chemotherapy for polymetastatic renal CDC, and experienced a late and prolonged complete remission. In June 2014, a 69‑year‑old male patient was diagnosed with non‑metastatic renal CDC. Nephrouretectomy was firstly performed. In December 2014, he developed a loco‑regional recurrence with bilateral lung metastases. The patient started a course of gemcitabine‑carboplatin (GC)‑based first‑line chemotherapy and received 6 cycles, which ended in May 2015. Computed tomography (CT) scan evaluation displayed an objective response according to RECIST 1.1 criteria and a follow‑up of the patient was conducted. In August 2015, he had a second local relapse with new lung metastases. Despite a short disease‑free interval, 6 cycles of the same GC regimen were required, which ended in February 2016. The patient firstly exhibited a partial objective response after the first 3 cycles and a stable disease at the end of chemotherapy. During the follow‑up, a CT scan of his chest, abdomen and pelvis was performed every 3 months. From September 2016 to May 2017, despite no new specific treatments for his metastatic disease, the patient again experienced an objective and confirmed response on each CT‑scan evaluation until complete remission in May 2017. This case report highlights the efficacy of GC‑based chemotherapy, which is able to provide a durable and sometimes complete response in metastatic renal CDC, and suggests the potential of rechallenging with the same chemotherapy regimen, despite a short disease‑free interval. The originality of this case was demonstrated by the delayed complete response more than one year after the end of GC‑based second line chemotherapy. The patient remained disease‑free at his last CT‑scan evaluation in April 2018.
