# Combination therapy with toripalimab and lenvatinib in metastatic type 2 papillary renal cell carcinoma: a Case Report

## TL;DR

A 73-year-old man with metastatic type 2 kidney cancer showed improved outcomes with a combination of toripalimab and lenvatinib.

## Contribution

This case report demonstrates the potential efficacy of toripalimab and lenvatinib in treating metastatic type 2 papillary renal cell carcinoma.

## Key findings

- The patient showed a partial response with regression of metastases after 11 months of treatment.
- The combination therapy was well-tolerated with no serious adverse events.
- The case highlights the importance of accurate diagnosis for effective treatment.

## Abstract

Type 2 papillary renal cell carcinoma (PRCC) is an aggressive subtype of renal cell carcinoma with a poor prognosis. Diagnosis is challenging, particularly when presenting as a metastatic lung mass. This report describes a case of metastatic type 2 PRCC treated with first-line toripalimab (anti-PD-1) and lenvatinib (multikinase inhibitor), highlighting sustained clinical benefit.

A 73-year-old man presented with cough, hemoptysis, and a large left lung mass initially misdiagnosed as primary lung cancer. Multidisciplinary re-evaluation, including immunohistochemistry (PAX8+, P504s+, also known as AMACR), confirmed metastatic type 2 PRCC. After 11 months of toripalimab (flat dose of 240 mg every 3 weeks) and lenvatinib (flat dose of 8 mg daily), serial imaging demonstrated partial response (PR) with regression of pulmonary metastases, lymphadenopathy, and obstructive pneumonia. No serious adverse events occurred.

This case underscores the potential efficacy and tolerability of toripalimab-lenvatinib combination therapy in metastatic type 2 PRCC. Further clinical trials are warranted to validate this approach.