Niraparib是一种多聚ADP核糖聚合酶抑制剂（PARPi），已广泛应用于上皮性卵巢癌、输卵管癌或原发性腹膜癌的干预。然而，截至目前，只有有限的实例表明尼拉帕尼治疗透明细胞肾细胞癌 (ccRCC) 患者取得了良好的结果。在此，我们报告一例 50 岁的 ccRCC 患者，该患者随后发展为远处转移。该患者接受了帕唑帕尼单药治疗以及阿西替尼和替雷利珠单抗联合治疗，但疗效有限。液体活检显示同源重组修复 (HRR) 途径的 CDK12 和 RAD51C 存在错义突变，表明对 PARPi 具有潜在敏感性。 niraparib治疗后，患者病情得到改善，且无明显副作用。综上所述，携带HRR通路基因突变的ccRCC患者可能会从niraparib中获益。这将为对传统治疗反应有限的 ccRCC 患者提供更多选择。版权所有 © 2024 Yue、Yang、Cao 和 Li。

Niraparib, a poly ADP-ribose polymerase inhibitors (PARPi), has been widely applied in the intervention of epithelial ovarian, fallopian tube, or primary peritoneal cancer. Nevertheless, as of the present moment, there are limited instances demonstrating favorable outcomes stemming from niraparib therapy in patients with clear cell renal cell carcinoma (ccRCC).Here, we report a case of a 50-year-old patient with ccRCC who subsequently developed distant metastasis. The patient received monotherapy with pazopanib and combination therapy with axitinib and tislelizumab, demonstrating limited efficacy. Liquid biopsy revealed missense mutations in the CDK12 and RAD51C of the homologous recombination repair (HRR) pathway, suggesting potential sensitivity to PARPi. Following niraparib treatment, the patient's condition improved, with no significant side effects.In summary, patients with ccRCC harboring HRR pathway gene mutation may potentially benefit from niraparib. This will present more options for ccRCC patients with limited response to conventional treatments.Copyright © 2024 Yue, Yang, Cao and Li.