Pathological complete response of renal cell carcinoma with vena cava tumor thrombus to neoadjuvant TKI/IO combination therapy.

Abstract A 79-year-old female was diagnosed with a right renal tumor with a level II tumor thrombus of the vena cava. presurgical therapy was initiated with a combination of avelumab and axitinib for 3 monthes. Then, she underwent nephrectomy and thrombectomy. Histologically, the primary tumor and tumor thrombus had no viable cells, indicating that pathological complete response was achieved with presurgical tyrosine kinase inhibitor/Immuno-oncology combination therapy. An immunohistological xamination showed very strong staining for tumor-infiltrating lymphocytes in the embolized area of the tumor, with CD8 predominating over CD4.