Session Name: Non-PTLD/Malignancies
Session Date & Time: None. Available on demand.
*Purpose: Solid organ transplant patients due to chronic immunosuppression have an increased risk of de novo cancer. Immune checkpoint inhibitors have been recently developed to treat cancer, however, solid organ transplant recipients with cancer have been excluded from clinical trials due to risk of rejection and graft failure. The purpose of our study was to evaluate the outcomes of immune checkpoint inhibitor therapy in solid organ transplant patients with metastatic cancer
*Methods: Solid organ transplant patients with metastatic cancer who underwent immune checkpoint inhibitor treatment until 2020 at Seoul National University hospital were retrospectively reviewed. We evaluated the tumor response, rejection, graft failure and overall survival after PD-1 treatment, either nivolumab or pembrolizumab.
*Results: Total of six solid organ transplant recipients, 2 kidney and 4 liver transplant, with metastatic cancer who received PD-1 inhibitor treatment were included in the study. The type of primary cancer consisted of 2 hepatocellular carcinomas, 2 skin cancers and 2 lung cancers. 4 patients were diagnosed with cancer more than 10 years after transplantation (124.30-288.63 months) and the other two patients at 7.50 and 17.33 months. There was an addition of mTOR inhibitor after cancer diagnosis for 3 patients, however, there was no change in the immunosuppressive regimen after PD-1 inhibitor treatment for all six patients. The median overall survival was 9.18 (2.73-16.80) months since the start of PD-1 inhibitor treatment. There was no rejection or graft failure. Only 2 out of the 6 patients with stable disease continued more than 4 cycles and eventually all six patients showed progression of disease. There were two deaths related to infections such as atypical pneumonia and sepsis due to urinary tract infection.
*Conclusions: Solid organ transplant recipients had no rejections or graft loss after PD-1 inhibitor treatment for metastatic cancer. Further multicenter retrospective studies are needed to evaluate the efficacy and rejection risk of PD-1 treatment in transplant population.
To cite this abstract in AMA style:Chung C, Ko H, Kim H, Choi K, Han A, Min S, Kang H, Ha J. Pd-1 Inhibitor Treatment in Solid Organ Transplant Patients with Metastatic Cancer [abstract]. Am J Transplant. 2021; 21 (suppl 3). https://atcmeetingabstracts.com/abstract/pd-1-inhibitor-treatment-in-solid-organ-transplant-patients-with-metastatic-cancer/. Accessed June 18, 2021.
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