Safety and Efficacy of Immune Checkpoint Inhibitors in Patients With Metastatic Cancer Post Solid Organ Transplantation: A Case Report and Review of the Literature

Wong, Karlton; Shen, John; D’Ambruoso, Sarah; Stefanoudakis, Dimitrios; Drakaki, Alexandra

doi:10.1016/j.transproceed.2019.08.002

Cited by 10 publications

(5 citation statements)

References 34 publications

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“…This literature analysis and others 7,8,42,[51][52][53][54][55] provide an overview of the benefit and risk associated with ICI use in cancer management in transplantation. ICI are a useful tool in cancer management than can rarely be left aside in the setting of solid organ transplantation despite the risk of rejection.…”

Section: Multidisciplinary Decision Making Before Starting Ici In Sotrmentioning

confidence: 99%

“…However, in clinical practice, oncologists had to deal with cases of SOTR with chemotherapy-refractory cancer for whom ICI appeared as the only therapeutic option. Publications of individual cases and small series since 2015 and subsequent meta-analyses 7,8,42,[51][52][53][54][55] provided a preliminary overview of the risk and efficacy of ICI management in SOTR. For example, in several studies, it is now clear that SOTR treated with anti-PD-1 are at higher risk of transplant rejection than patients treated with anti-CTLA-4, 7,51,56 although nonsignificantly in some recent meta-analyses.…”

Section: Reviewmentioning

confidence: 99%

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Immune Checkpoint Inhibitors in Transplantation—A Case Series and Comprehensive Review of Current Knowledge

et al. 2020

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Cancer is a leading cause of morbidity and deaths in solid organ transplant recipients. In immunocompetent patients, cancer prognosis has been dramatically improved with the development of immune checkpoint inhibitors (ICI), as programmed cell death protein 1/programmed death-ligand 1 and cytotoxic T lymphocyte–associated antigen 4 inhibitors, that increase antitumor immune responses. ICI has been developed outside of the scope of transplantation because of the theoretical risk of graft rejection, which has later been confirmed by the publication of several cases and small series. The use of ICI became unavoidable for treating advanced cancers including in organ transplant patients, but their management in this setting remains highly challenging, as to date no strategy to adapt the immunosuppression and to prevent graft rejection has been defined. In this article, we report a monocentric series of 5 solid organ transplant recipients treated with ICI and provide a comprehensive review of current knowledge of ICI management in the setting of solid organ transplantation. Strategies warranted to increase knowledge through collecting more exhaustive data are also discussed.

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Section: Multidisciplinary Decision Making Before Starting Ici In Sotrmentioning

confidence: 99%

Section: Reviewmentioning

confidence: 99%

Immune Checkpoint Inhibitors in Transplantation—A Case Series and Comprehensive Review of Current Knowledge

et al. 2020

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“…Immunosuppression may predispose to cancer by inhibiting immune surveillance, suppressing DNA repair, and predisposing to oncogenic viral infections (48)(49)(50). Although transplant recipients have been excluded from all clinical trials of ICPIs to date, based on the concern of triggering rejection upon blockade of immune inhibitory signals, case reports and small case series of transplanted recipients receiving ICPIs have begun to emerge with conflicting results (51)(52)(53)(54)(55)(56)(57)(58)(59)(60)(61)(62). We reviewed all published case reports and case series and found that the rejection rate with ipilimumab monotherapy was 33% compared to 52% in patients receiving anti-PD-1 monotherapy (Figure 3) (63).…”

Section: What Are Special Considerations In Transplant Patients?mentioning

confidence: 99%

Immune Checkpoint Inhibitor Nephrotoxicity: Update 2020

et al. 2020

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Immune checkpoint inhibitors (ICPIs) have transformed the landscape of oncology, but are associated with a variety of autoimmune adverse events, including AKI. ICPI-associated AKI (ICPI-AKI) is emerging as an increasingly frequent cause of AKI in patients with cancer, and poses unique diagnostic and management challenges to clinicians who care for these patients. In this review, we describe the incidence and risk factors for ICPI-AKI, including proton pump inhibitor use, CKD, and combination immunotherapy. We discuss the limitations of the various definitions used for ICPI-AKI in prior studies, and propose a novel classification system (definite, probable, and possible ICPI-AKI) that recognizes the diagnostic uncertainty inherent in many cases. We discuss the key clinicopathologic features and treatment strategies for ICPI-AKI, including the role of kidney biopsy versus empirical treatment with steroids. We also explore the under-studied area of ICPI use in the setting of solid organ transplantation, where nephrologists and oncologists must balance the risk of rejection versus treating the underlying malignancy. Finally, we summarize existing data on the role of ICPI rechallenge after an episode of ICPI-AKI.

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“…Figura 2. Mecanismo de acción de los inhibidores del punto de control (21,22,30). Mecanismo de acción de los inhibidores de punto de control.…”

Section: Inhibidores Del Punto De Controlunclassified

Importancia del seguimiento a la función renal en la inmunoterapia.

Uribe-Ramírez

2022

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La elevada mortalidad en pacientes con cáncer ha impulsado el desarrollo de nuevas alternativas terapéuticas entre las que toma especial relevancia la inmunoterapia, un tipo de tratamiento en el que se emplean sustancias con el fin de estimular la respuesta inmune del organismo para combatir de manera más eficiente algunas patologías. Esta opción de tratamiento ha demostrado resultados más favorables que otras terapias, sin embargo, su implementación se ha asociado con lesiones renales agudas y nefrotoxicidad que es ocasionada principalmente por una desmesurada respuesta inmune que puede provocar disminución del flujo sanguíneo renal, lesiones del intersticio por infiltrados inflamatorios o fenómenos obstructivos. Si bien estos efectos adversos no se presentan con una alta frecuencia, se cree que los elementos utilizados en este tipo de terapia pueden ser la causa de un importante porcentaje de patologías renales en los pacientes que reciben el tratamiento.

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Safety and Efficacy of Immune Checkpoint Inhibitors in Patients With Metastatic Cancer Post Solid Organ Transplantation: A Case Report and Review of the Literature

Cited by 10 publications

References 34 publications

Immune Checkpoint Inhibitors in Transplantation—A Case Series and Comprehensive Review of Current Knowledge

Immune Checkpoint Inhibitors in Transplantation—A Case Series and Comprehensive Review of Current Knowledge

Immune Checkpoint Inhibitor Nephrotoxicity: Update 2020

Importancia del seguimiento a la función renal en la inmunoterapia.

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