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.

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