Background and Objectives: Complete pathological response after ipilimumab and nivolumab combination therapy in a patient with intermediate prognosis renal cell carcinoma is an uncommon finding. Case presentation: A 60-year-old man presented with synchronous solitary metastatic bone lesion and renal cell carcinoma and achieved a complete pathological response after surgical resection of the bone lesion, followed by ipilimumab and nivolumab combination therapy and nephrectomy. The treatment was complicated by hypophysitis and oligoarthritis more than a year after the initiation of the therapy. Conclusions: Currently, the combination therapy based on immune checkpoint inhibitors represents the treatment of choice in patients with intermediate- and poor-risk prognosis metastatic renal cell carcinoma. In the present case, preoperative therapy with ipilimumab and nivolumab resulted in a complete pathological response in the renal tumor. Vigilance concerning potential immune-related side effects is warranted throughout the course of therapy and the subsequent follow-up.

Department of Clinical and Molecular Pathology Faculty of Medicine and Dentistry Palacky University Olomouc and University Hospital Olomouc 1 P Pavlova 6 77900 Olomouc Czech Republic

Department of Oncology Faculty of Medicine and Dentistry Palacky University Olomouc and University Hospital Olomouc 1 P Pavlova 6 77900 Olomouc Czech Republic

Department of Radiology Faculty of Medicine and Dentistry Palacky University Olomouc and University Hospital Olomouc 1 P Pavlova 6 77900 Olomouc Czech Republic

Department of Urology Faculty of Medicine and Dentistry Palacky University Olomouc and University Hospital Olomouc 1 P Pavlova 6 77900 Olomouc Czech Republic

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The Evolving Landscape of Cytoreductive Nephrectomy in Metastatic Renal Cell Carcinoma

Neoadjuvant nivolumab and cabozantinib in advanced renal cell carcinoma in a horseshoe kidney - how to achieve a safe and radical resection? a case report and review of the literature