Acute renal allograft rejection after immune checkpoint inhibitor therapy for metastatic melanoma

L Spain; R Higgins; K Gopalakrishnan; S Turajlic; M Gore; J Larkin

doi:10.1093/annonc/mdw130

Acute renal allograft rejection after immune checkpoint inhibitor therapy for metastatic melanoma

Ann Oncol. 2016 Jun;27(6):1135-1137. doi: 10.1093/annonc/mdw130. Epub 2016 Mar 6.

Authors

L Spain¹, R Higgins², K Gopalakrishnan², S Turajlic³, M Gore¹, J Larkin⁴

Affiliations

¹ Royal Marsden NHS Foundation Trust, London.
² University Hospitals Coventry and Warwickshire, Coventry.
³ Royal Marsden NHS Foundation Trust, London; The Francis Crick Institute, Lincoln's Inn Fields Laboratory, London, UK.
⁴ Royal Marsden NHS Foundation Trust, London. Electronic address: james.larkin@rmh.nhs.uk.

PMID: 26951628
DOI: 10.1093/annonc/mdw130

Abstract

Immune checkpoint inhibitors such as ipilimumab and nivolumab improve survival in patients with advanced melanoma and are increasingly available to clinicians for use in the clinic. Their safety in organ transplant recipients is not well defined but published case reports describing treatment with ipilimumab have not been complicated by graft rejection. No cases of anti-programmed cell death protein 1 administration are reported in this group. We describe a case of acute graft rejection in a kidney transplant recipient after treatment with nivolumab, after progression on ipilimumab. Potential factors increasing the risk of graft rejection in this case are discussed, in particular the contribution of nivolumab.

Keywords: acute rejection; immune checkpoint inhibitor; kidney transplant; metastatic melanoma.

Publication types

Case Reports

MeSH terms

Antibodies, Monoclonal / administration & dosage
Antibodies, Monoclonal / adverse effects
Antibodies, Monoclonal, Humanized / administration & dosage
Antibodies, Monoclonal, Humanized / adverse effects
B7-H1 Antigen / genetics
B7-H1 Antigen / immunology
B7-H1 Antigen / metabolism
CTLA-4 Antigen / genetics
CTLA-4 Antigen / immunology
Graft Rejection / genetics
Graft Rejection / immunology*
Graft Rejection / pathology
Humans
Immunosuppressive Agents / administration & dosage*
Immunosuppressive Agents / adverse effects
Kidney / drug effects
Kidney / pathology
Male
Melanoma / drug therapy*
Melanoma / genetics
Melanoma / immunology
Middle Aged
Neoplasm Metastasis
Nivolumab
Programmed Cell Death 1 Receptor / genetics
Programmed Cell Death 1 Receptor / immunology
Transplantation, Homologous
Tumor Microenvironment / drug effects

Substances

Antibodies, Monoclonal
Antibodies, Monoclonal, Humanized
B7-H1 Antigen
CD274 protein, human
CTLA-4 Antigen
Immunosuppressive Agents
PDCD1 protein, human
Programmed Cell Death 1 Receptor
Nivolumab
pembrolizumab

Grants and funding

18176/CRUK_/Cancer Research UK/United Kingdom