Checkpoint Inhibitor-Induced Allograft Rejection in Patients with Cancer and Prior Solid Organ Transplantation
| Prior organ transplantation | Checkpoint inhibitor | Allograft rejection, no./reported cases (%) | Median time to rejection, days (range) |
|---|---|---|---|
| All | 16/39 (41) | 15.5 (5–60) | |
| Renal | Ipilimumab | 2/4 (50) | 21 |
| Nivolumab | 2/5 (40) | 18.5 (7–30) | |
| Pembrolizumab | 4/9 (44) | 21 (5–60) | |
| Ipilimumab + nivolumab | 1/1 (100) | 8 | |
| Ipilimumab followed by nivolumab or pembrolizuamba | 2/4 (50) | 14.5 (8–21) | |
| All | 11/23 (48) | 21 (5–60) | |
| Hepatic | Ipilimumab | 1/3 (33) | 13 |
| Nivolumab | 2/4 (50) | 12.5 (7–18) | |
| Pembrolizumab | 1/3 (33) | 7 | |
| Ipilimumab followed by pembrolizumaba | 0/1 (0) | ||
| All | 4/11 (36) | 10 (7–18) | |
| Cardiac | Ipilimumab | 0/1 (0) | |
| Nivolumab | 1/2 (50) | 5 | |
| Pembrolizumab | 0/1 (0) | ||
| Ipilimumab followed by pembrolizumaba | 0/1 (0) | ||
| All | 1/5 (20) | 5 |
aSix patients switched to anti-PD-1 agents after progression with ipilimumab alone. For those patients, median time to rejection (when it occurred) was calculated as the time from first infusion of the last checkpoint inhibitor agent until allograft rejection