Application of Immune Checkpoint Inhibitors in Solid Organ Transplantation Recipients: A Systematic Review

Prompt response of advanced cutaneous squamous cell carcinoma to cemiplimab in a kidney transplant patient receiving treatment with everolimus

“…In contrast to most other organ transplants, kidney transplant may be considered only a relative contraindication, as ICI‐induced graft rejection in SOTRs appears not to affect overall survival. In the worst case, kidney recipients with a failing transplant under ICI treatment could be restarted on dialysis to replace renal function 1–4 . Interestingly, many clinical trials have shown that mammalian target of rapamycin (mTOR) inhibitors significantly reduce tumour size in transplant recipients with cSCC.…”

“…However, it has to be stressed that the progression of cSCC, for example, is more frequently the reason for death rather than transplant rejection. Observational studies and systematic analyses of case reports and case series provide evidence that ICIs may be feasible in SOTRs with advanced cSCC, particularly in patients with kidney transplant 1–4 . In contrast to most other organ transplants, kidney transplant may be considered only a relative contraindication, as ICI‐induced graft rejection in SOTRs appears not to affect overall survival.…”

“…Observational studies and systematic analyses of case reports and case series provide evidence that ICIs may be feasible in SOTRs with advanced cSCC, particularly in patients with kidney transplant. [1][2][3][4] In contrast to most other organ transplants, kidney transplant may be considered only a relative contraindication, as ICI-induced graft rejection in SOTRs appears not to affect overall survival. In the worst case, kidney recipients with a failing transplant under ICI treatment could be restarted on dialysis to replace renal function.…”

“…Prompt response of advanced cutaneous squamous cell carcinoma to cemiplimab in a kidney transplant patient receiving treatment with everolimus doi: 10.1111/ced.15018 Dear Editor, Immune checkpoint inhibitors (ICIs) are increasingly being used in numerous advanced solid cancers; however, their safety and efficacy in solid organ transplant recipients (SOTRs) are unclear, as SOTRs are usually excluded from clinical investigations because of their high risk for irreversible allograft rejection. [1][2][3][4] We report the case of an SOTR with metastatic cutaneous squamous cell carcinoma (cSCC) who experienced complete response while receiving anti-tumour therapy using cemiplimab and prevention of transplant rejection by fixed-dose everolimus.…”

“…In the worst case, kidney recipients with a failing transplant under ICI treatment could be restarted on dialysis to replace renal function. [1][2][3][4] Interestingly, many clinical trials have shown that mammalian target of rapamycin (mTOR) inhibitors significantly reduce tumour size in transplant recipients with cSCC. The phosphoinositide 3-kinase/AKT/mTOR pathway is frequently activated in various SCCs.…”