Choosing Second-Line Therapy for Metastatic Kidney Cancer: Case 1
Choosing Second-Line Therapy for Metastatic Kidney Cancer
Case Scenario 1: A 50-year old male with relapse of metastatic RCC
January 2014
- A 48-year old Caucasian man presented to his physician complaining of right upper quadrant discomfort and back pain
- CT scan of the abdomen and pelvis showed a large right renal mass with retroperitoneal adenopathy, largest node measuring 2.5 cm on right axis; metastatic lesion to T9, lytic
- The patient underwent cytoreductive nephrectomy, retroperitoneal node biopsy
- He was diagnosed with stage IV renal cell carcinoma, clear-cell histology, with metastases to bone and contralateral adrenal gland
- After radiation therapy to T8, he was then started on pazopanib 800 mg
- The first follow up scan showed a decrease in size of the adrenal lymph node
- The patient reported moderate diarrhea and mild fatigue which was controlled with antidiarrheal medication and rest
- He continues to do well with improved tolerance after dose adjustment to 600 mg
April 2016
- Imaging shows slow but steady progression in the adrenal lesion
- The patient complains of increasing back pain. He reports nausea and
- Pazopanib was discontinued and the patient was started on cabozantinib 60 mg
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