AccScience Publishing / ARNM / Volume 1 / Issue 1 / DOI: 10.36922/arnm.0441
CASE REPORT

PRaG regimens for rechallenge in a patient with acquired resistance to PD-1 inhibitor in advanced refractory renal pelvis carcinoma: A case report

Zhihui Hong1,2,3† Hong Xu4,5† Yuehong Kong5,6,7 Meiling Xu5,6,7 Yifu Ma5,6,7 Pengfei Xing5,6,7* Liyuan Zhang5,6,7*
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1 Department of Nuclear Medicine, The Second Affiliated Hospital of Soochow University, Suzhou, 215005 Jiangsu, China
2 State Key Laboratory of Radiation Medicine and Protection, Soochow University, Suzhou, 215123, Jiangsu, China
3 INHC Key Laboratory of Nuclear Medicine and Jiangsu Key Laboratory of Molecular Nuclear Medicine, Wuxi, 214063, Jiangsu, China
4 Department of Oncology, Changshu Hospital Affiliated to Soochow University, Suzhou, 215488 Jiangsu, China
5 Department of Radiotherapy and Oncology, The Second Affiliated Hospital of Soochow University, Suzhou, 215005 Jiangsu, China
6 Institution of Radiotherapy and Oncology, Soochow University, Suzhou, 215123 Jiangsu, China
7 Laboratory for Combined Radiotherapy and Immunotherapy of Cancer, The Second Affiliated Hospital of Soochow University, Suzhou, 215005 Jiangsu, China
Submitted: 13 April 2023 | Accepted: 29 June 2023 | Published: 12 July 2023
© 2023 by the Author(s). This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution 4.0 International License ( https://creativecommons.org/licenses/by/4.0/ )
Abstract

Despite the burgeoning popularity of programmed death-1 (PD-1) inhibitors in cancer treatment, it is not uncommon for patients who initially respond to this therapy to experience relapse over time. Here, we present the case of a patient with advanced renal pelvis carcinoma who had received prior treatment with chemotherapy and PD-1 inhibitor therapy but ultimately experienced disease progression. Subsequently, the patient underwent a combination therapy known as PRaG 2.0, which included PD-1 inhibitor, radiotherapy, granulocyte-macrophage colony-stimulating factor, and interleukin-2, resulting in effective disease control without significant adverse events. The duration of disease control lasted for a period of 10 months.

Keywords
PD-1 inhibitor
Radiotherapy
PRaG therapy
Rechallenge
Renal pelvis carcinoma
Funding
National Natural Science Foundation of China
Key R&D Programme of Jiangsu Province
Suzhou Radiotherapy Clinical Medical Center
Open Project of the State Key Laboratory of Radiology and Radiation Protection of Soochow University
Open Project of Provincial Key Laboratory of Soochow University
Subject construction support project of the Second Affiliated Hospital of Soochow University
Suzhou Science and Technology Development Plan
Chinese Society of Clinical Oncology Research Foundation of Beijing
Wu Jieping Medical Foundation
Special project of “Technological Innovation” project of CNNC Medical Industry Co. Ltd
Suzhou Science and Education Health Project
Postgraduate Research & Practice Innovation Program of Jiangsu Province
Suzhou Key Laboratory for Combined Radiotherapy and Immunotherapy of Cancer
Suzhou Clinical Key Diseases Diagnosis and Treatment Technology Special Project
Csco fund
2021 “Nuclear Medicine Technology Innovation” Project of CNNC Medical
Research project of China Baoyuan Investment Co., Ltd.
Project of State Key Laboratory of Radiation Medicine and Protection, Soochow University
Subject construction support project of the Second Affiliated Hospital of Soochow University
Open Program of NHC Key Laboratory of Nuclear Medicine and Jiangsu Key Laboratory of Molecular Nuclear Medicine
Conflict of interest
The authors declare they have no competing interests.
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Advances in Radiotherapy & Nuclear Medicine, Electronic ISSN: 2972-4392 Published by AccScience Publishing