Reintroducing Pazopanib Reverses the Primary Resistance of Nivolumab in a Patient With Metastatic Clear-cell Renal Cell Carcinoma

Nivolumab is the mainstay treatment for vascular endothelial growth factor-tyrosine kinase inhibitor pretreated metastatic clear-cell renal cell carcinoma. For patients who are unresponsive to nivolumab, there is no accepted standard third-line treatment. We report an interesting treatment experience on a patient who had de novo resistance to nivolumab. By retroducing previously unresponsive pazopanib with nivolumab, the patient had a remarkable response without any additional toxicity. Combining vascular endothelial growth factor-tyrosine kinase inhibitor with immune checkpoint inhibitors has promising anti-tumor activity. Further prospective clinical trials are warranted. (C) 2017 Elsevier Inc. All rights reserved.