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Renal cell carcinoma (RCC) has long been recognised as an immunologically sensitive tumour with a distinctive response to high-dose interleukin-2 and interferon-α. In the CheckMate025 randomised phase 3 study, nivolumab, an immunoglobulin G4 monoclonal antibody against PD-1, was shown to improve the response rate and overall survival in patients with advanced RCC who were previously treated with one or more antiangiogenic agents compared with everolimus.1-3 Heterogeneous post-treatment response patterns are observed during immunotherapy.4 In addition to conventional response patterns, hyperprogressive disease (HPD) is a novel observation. We report a case of metastatic clear cell RCC (ccRCC) presenting with this novel aggressive phenomenon during the initial phase of immunotherapy.

Metastatic Clear Cell Renal Cell Carcinoma with Hyperprogressive Disease after Anti–Programmed Death-1 Immunotherapy: A Case Report