Date: Saturday, June 2, 2018
Session Time: 5:30pm-7:30pm
Presentation Time: 5:30pm-7:30pm
Location: Hall 4EF
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.
|Patient demographics||Type of malignancy||Time since transplant until development of cancer (years)||CPI used||Creatinine before CPI initiation||Current state of allograft||Current state of cancer||Time to AKI(weeks)|
|69 yo Caucasian male||Skin squamous cell||4||Pembrolizumab||0.9||ESRD||Worsening||4|
|67yo Caucasian male||Squamous cell||22||Pembrolizumab||1.6||Stable||Improving||NA|
|38yo Caucasian male||Malignant melanoma||19||Pembrolizumab,Ipilimumab + Nivolumab||1.3||Stable||Worsening||NA|
|68yo Caucasian male||Malignant melanoma||15||Ipilimumab followed by Pembrolizumab||1.1||ESRD||Improving||3|
|58yo Caucasian female||Lung adenocarcinoma||6||Pembrolizumab||1.0||Stable||Stable||NA|
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).
To cite this abstract in AMA style:Venkatachalam K, Delos R, Alhamad T. Single Center Experience in Use of Check Point Inhibitors and Outcomes in Kidney Transplant Recipients [abstract]. https://atcmeetingabstracts.com/abstract/single-center-experience-in-use-of-check-point-inhibitors-and-outcomes-in-kidney-transplant-recipients/. Accessed April 19, 2019.
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