随着免疫检查点抑制剂（ICIs）的快速发展，它在治疗各种癌症方面显示出显着的临床益处。然而，免疫相关不良事件（irAE）仍然是接受免疫治疗的患者管理中的重大挑战。关于在初始 ICI 治疗中出现 irAE 的肾透明细胞癌患者再次接受免疫治疗的数据有限。在这项研究中，我们报道了一位晚期肾透明细胞癌患者的病例，该患者出现了严重的irAE，但在ICI联合帕唑帕尼一线治疗后也实现了肿瘤的部分缓解。静脉注射甲泼尼龙治疗两周后，患者从治疗相关的毒性中完全康复。经过多学科治疗（MDT）讨论以及与患者的沟通，决定接受新型全人源化程序性死亡1（PD-1）药物zimberelimab联合帕唑帕尼进行免疫重启治疗。经过两个周期的治疗后，患者表现出部分缓解（PR），并且在治疗 14 个月后的最后一次随访时，疾病保持持续缓解，没有任何 irAE。 irAE 后重新接受免疫治疗是一种新兴策略，可为之前有反应的患者带来额外的临床益处。然而，仔细的患者选择和监测对于最大限度地提高这种方法的安全性和有效性至关重要。版权所有 © 2023 He、Wang、Sun、Du 和 Yu。

With the rapidly evolving of immune checkpoint inhibitors (ICIs), it has shown remarkable clinical benefits in treating various cancers. However, immune-related adverse events (irAEs) remain a significant challenge in the management of patients undergoing immunotherapy. There are limited data about immunotherapy re-challenge in patients with renal clear cell cancer who had irAE in the initial ICI therapy. In this study, we reported the case of a patient with advanced renal clear cell cancer who developed serious irAEs but also achieved a partial remission of tumor after ICI combined with pazopanib in the first-line treatment. After intravenous methylprednisolone therapy for two weeks, the patient fully recovered from treatment-related toxicities. After a multidisciplinary treatment (MDT) discussion and a communication with the patient, the decision was made to undergo a new fully humanized programmed death 1 (PD-1) agent, zimberelimab, combined with pazopanib for immune restart therapy. After two cycles of treatment, the patient demonstrated a partial response (PR), and the disease remained in continuous remission without any irAE at our last follow-up after 14 months' treatment. Re-challenging with immunotherapy after irAEs is an emerging strategy that offers the potential for additional clinical benefits to previously responding patients. However, careful patient selection and monitoring are essential to maximize the safety and efficacy of this approach.Copyright © 2023 He, Wang, Sun, Du and Yu.