Organ transplant recipients who are on lifelong immunosuppressive agents are those who are at increased risk of malignancies (excess absolute risk of 719 cases per 100,000 person-years). Check point (CTLA4 and PD-1) inhibitors (CPI) are a class of drugs that have recently been used as immunotherapy in treatment of malignancies that are unresponsive to standard chemotherapy regimens. They are largely used in treatment of skin cancers (melanoma, squamous cell), renal cell carcinoma, non-small cell lung cancer. Programmed death 1 (PD-1) receptor and one of its ligands (PD-L1) have produced tumor regressions in multiple cancer types. These therapies are untested in patients treated with long-term immunosuppressive medications. We present our center's experience of 5 kidney transplant recipients, treated with check point inhibitors, their post therapy course and the fate of their allograft.

The above mentioned 5 patients received induction therapy with rabbit anti-thymocyte globulin at the time of transplant and were on maintenence immunosuppression with Calcinurin inhibitor (CNI) (Cyclosporine / tacrolimus [immediate/extended release]), mycophenolic acid and prednisone. All patients were treated for their respective malignancies with standard chemotherapy before being treated with CPIs. Patients who progressed to ESRD had acute cellular and antibody mediated rejection. Patients with stable allografts are maintained on CNI free regimen with mTOR inhibitor and prednisone.

CITATION INFORMATION: Venkatachalam K., Delos Santos R., Alhamad T. Single Center Experience in Use of Check Point Inhibitors and Outcomes in Kidney Transplant Recipients Am J Transplant. 2017;17 (suppl 3).

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