Journal
MELANOMA RESEARCH
Volume 28, Issue 1, Pages 61-64Publisher
LIPPINCOTT WILLIAMS & WILKINS
DOI: 10.1097/CMR.0000000000000410
Keywords
antirejection immunosuppression; immunotherapy; ipilimumab; melanoma; pembrolizumab; transplant recipient
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Immunotherapy with immune checkpoint inhibitors (ICIs) may be considered as a treatment option for various types of tumors, but the transplant recipient population as well as patients requiring long-term systemic immunosuppression for other reasons have been systematically excluded from clinical trials involving ICIs. We report a case of successful treatment with ICI in a liver transplant recipient diagnosed with a rare subtype of melanoma. This patient had not required any modification to her antirejection immunosuppression before or during immunotherapy, had not experienced any serious immune-related adverse event, and had a durable objective response for nearly 1.5 year now. A summary of a literature review on other case reports is included to show that ICIs can be safe and provide clinically meaningful benefit in transplant patients, although acute rejection and graft loss remain a significant risk. Given the serious complication of graft failure, a detailed discussion of risks and benefits with immunotherapy needs to be made for an informed consent. Nevertheless, transplant recipients with cancer should not be deprived of this potentially life-saving or life-prolonging treatment, and inclusion of this population in future clinical trials should be considered. Copyright (C) 2018 Wolters Kluwer Health, Inc. All rights reserved.
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