{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,29]],"date-time":"2025-10-29T03:51:37Z","timestamp":1761709897298,"version":"3.44.0"},"reference-count":10,"publisher":"BMJ","issue":"6","funder":[{"DOI":"10.13039\/100000054","name":"National Cancer Institute","doi-asserted-by":"publisher","award":["NIH F30CA236031"],"award-info":[{"award-number":["NIH F30CA236031"]}],"id":[{"id":"10.13039\/100000054","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2021,6,1]]},"published-print":{"date-parts":[[2021,6]]},"abstract":"<jats:p>While half of the metastatic clear cell renal cell carcinomas (ccRCCs) involve the lungs, metastatic lesions have been described in various other organs, including glandular tissues such as the pancreas. Recent evidence suggests that ccRCC lesions affecting the pancreas are poorly responsive to immune checkpoint inhibition (ICI) but show superior responses to tyrosine kinase inhibitors (TKIs) targeting the vascular endothelial growth factor (VEGF) signalling pathway. However, this has yet to be explored in ccRCC spreading to other glandular tissues. Here we present two cases of ccRCC with glandular metastases, the first to the pancreas and the second to the parotid gland. In both patients, ICI-based immunotherapy offered minimal clinical benefit, but both had durable responses to angiogenesis inhibitors. Given the anatomic similarity between the pancreas and parotid glands, ccRCC with involvement of the parotid gland may also benefit from VEGF-targeting TKIs as opposed to ICIs.<\/jats:p>","DOI":"10.1136\/bcr-2021-243259","type":"journal-article","created":{"date-parts":[[2021,6,22]],"date-time":"2021-06-22T12:03:41Z","timestamp":1624363421000},"page":"e243259","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":5,"title":["Glandular metastases from renal cell carcinoma show poor clinical responses to immune checkpoint inhibition but durable responses to angiogenesis inhibitors"],"prefix":"10.1136","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4355-6597","authenticated-orcid":false,"given":"Daniel R","family":"Principe","sequence":"first","affiliation":[{"name":"Medical Scientist Training Program, University of Illinois College of Medicine, Chicago, Illinois, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Brian C","family":"Schulte","sequence":"additional","affiliation":[{"name":"Department of Medicine, Division of Hematology and Oncology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Suneel D","family":"Kamath","sequence":"additional","affiliation":[{"name":"Department of Medicine, Division of Hematology and Oncology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hidayatullah G","family":"Munshi","sequence":"additional","affiliation":[{"name":"Department of Medicine, Division of Hematology and Oncology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2021,6,22]]},"reference":[{"key":"2025082711524824000_14.6.e243259.1","doi-asserted-by":"publisher","DOI":"10.3322\/caac.21654"},{"key":"2025082711524824000_14.6.e243259.2","doi-asserted-by":"publisher","DOI":"10.1093\/annonc\/mdr362"},{"key":"2025082711524824000_14.6.e243259.3","doi-asserted-by":"crossref","first-page":"4747","DOI":"10.3748\/wjg.v17.i43.4747","article-title":"Pancreatic metastases from renal cell carcinoma: the state of the art","volume":"17","author":"Ballarin","year":"2011","journal-title":"World J Gastroenterol"},{"key":"2025082711524824000_14.6.e243259.4","doi-asserted-by":"crossref","DOI":"10.1172\/jci.insight.134564","article-title":"Pancreatic tropism of metastatic renal cell carcinoma","volume":"5","author":"Singla","year":"2020","journal-title":"JCI Insight"},{"key":"2025082711524824000_14.6.e243259.5","doi-asserted-by":"publisher","DOI":"10.1097\/00005537-200203000-00009"},{"key":"2025082711524824000_14.6.e243259.6","doi-asserted-by":"crossref","DOI":"10.3390\/biomedicines8060178","article-title":"Defining parallels between the salivary glands and pancreas to better understand pancreatic carcinogenesis","volume":"8","author":"Tiffon","year":"2020","journal-title":"Biomedicines"},{"key":"2025082711524824000_14.6.e243259.7","unstructured":"National Cancer Institute . Renal Cell Cancer Treatment (PDQ(R)): Health Professional Version. PDQ Cancer Information Summaries. Bethesda (MD: National Cancer Institute (US), 2002."},{"key":"2025082711524824000_14.6.e243259.8","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1712126"},{"key":"2025082711524824000_14.6.e243259.9","doi-asserted-by":"crossref","first-page":"1083","DOI":"10.1097\/COC.0000000000000429","article-title":"Pembrolizumab for the treatment of advanced salivary gland carcinoma: findings of the phase 1B KEYNOTE-028 study","volume":"41","author":"Cohen","year":"2018","journal-title":"Am J Clin Oncol"},{"key":"2025082711524824000_14.6.e243259.10","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/j.canlet.2021.01.031","article-title":"Trials and tribulations of pancreatic cancer immunotherapy","volume":"504","author":"Principe","year":"2021","journal-title":"Cancer Lett"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2021-243259","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,27]],"date-time":"2025-08-27T18:52:55Z","timestamp":1756320775000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2021-243259"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,6]]},"references-count":10,"journal-issue":{"issue":"6","published-online":{"date-parts":[[2021,6,22]]},"published-print":{"date-parts":[[2021,6]]}},"alternative-id":["10.1136\/bcr-2021-243259"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2021-243259","relation":{},"ISSN":["1757-790X"],"issn-type":[{"type":"electronic","value":"1757-790X"}],"subject":[],"published":{"date-parts":[[2021,6]]}}}