{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,14]],"date-time":"2026-07-14T07:05:37Z","timestamp":1784012737137,"version":"3.55.0"},"reference-count":25,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,11,6]],"date-time":"2025-11-06T00:00:00Z","timestamp":1762387200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Immunol."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Case presentation<\/jats:title>\n                    <jats:p>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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>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.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fimmu.2025.1591489","type":"journal-article","created":{"date-parts":[[2025,11,6]],"date-time":"2025-11-06T05:29:01Z","timestamp":1762406941000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":1,"title":["Combination therapy with toripalimab and lenvatinib in metastatic type 2 papillary renal cell carcinoma: a Case 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