ArticleJournal of clinical oncology : official journal of the American Society of Clinical Oncology2024
Nivolumab + Tacrolimus + Prednisone ± Ipilimumab for Kidney Transplant Recipients With Advanced Cutaneous Cancers.
Article in Journal of clinical oncology : official journal of the American Society of Clinical Oncology, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 42 papers, 1 of them a synthesis that pooled it.
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Who cites it
42 citing papers in PubMed, 1 synthesis or guideline pooled it, 48 citations in OpenAlex.
- Updated pan-tumor guidelines for neoadjuvant scoring of pathologic response: a joint SITC and INMC effort.Annals of oncology : official journal of the European Society for Medical Oncology · 2026Guideline
- The Immune Checkpoint Inhibitors Journey: From Early Promise to Lasting Impact.Journal of immunotherapy and precision oncology · 2026Review
- Immune Checkpoint Inhibitor-Associated Acute Kidney Injury: A Report from the 34th Acute Disease Quality Initiative (ADQI) Consensus Conference.Journal of the American Society of Nephrology : JASN · 2026Article
- Immune Checkpoint Inhibitor Therapy of Malignancy in Kidney Transplant Recipients: Analysis of Real-world Outcomes.Transplantation direct · 2026Article
- Requiring Caution in the Interpretation of Donor-Derived Cell-Free DNA Levels During Cancer Treatment in a Kidney Transplant Recipient.: A Case Report.IJU case reports · 2026Article
- Ten tips on how to prevent and manage post-transplant lymphoproliferative disease in kidney transplant recipients.Clinical kidney journal · 2026Review
- Second-line treatments for patients with programmed cell death protein 1-refractory cutaneous squamous cell carcinomas: a brief report.The oncologist · 2026Article
- Review
- Tumor Infiltrating Lymphocytes in Cutaneous Squamous Cell Carcinoma-A Systematic Review.Dermatopathology (Basel, Switzerland) · 2026Review
- Optimized patient-derived lung cancer organoids recapitulating the immune landscape for precision therapy evaluation.Cellular oncology (Dordrecht, Netherlands) · 2026Article
- Advances in Targeted and Immunotherapy for High-Risk Cutaneous Malignancies.Oncology research · 2026Review
- Novel Immunotherapeutic Approaches for Patients with Head and Neck Cutaneous Squamous Cell Carcinoma.Oncology research · 2026Review
- Onco-nephrology in kidney transplant recipients: challenges and evolving strategies.Frontiers in immunology · 2026Review
- Donor-transmitted squamous cell carcinoma in kidney transplant recipient successfully treated with checkpoint inhibitors: a case report.Frontiers in oncology · 2026Article
- Risk stratification by donor-derived cell-free DNA: a three-year single center study of kidney transplant outcomes from 257 patients.Frontiers in immunology · 2026Article
- Non-DLBCL monomorphic and Hodgkin lymphoma PTLD: clinical insights and treatment strategies.Blood advances · 2025Review
- Merkel cell carcinoma in solid organ transplant recipients: prognosis and response to immunotherapy.The British journal of dermatology · 2025Article
- Review
- Review
- Immune Checkpoint Inhibitors in Kidney Transplant Recipients: A French Multicenter Retrospective Cohort Study.Transplantation direct · 2025Article
Corrections and comments
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Authors and funding
26 authors at 8 institutions in 1 country.
Funding
Abstract
purposeCancer-related mortality rates among kidney transplant recipients (KTR) are high, but these patients have largely been excluded from trials of immune checkpoint inhibitors because of immunosuppression and risk of treatment-related allograft loss (TRAL). We conducted a prospective clinical trial testing nivolumab (NIVO) + tacrolimus (TACRO) + prednisone (PRED) ± ipilimumab (IPI) in KTR with advanced cutaneous cancers.
methodsAdult KTR with advanced melanoma or basal, cutaneous squamous, or Merkel cell carcinomas were eligible. Immunosuppression was standardized to TACRO (serum trough 2-5 ng/mL) + PRED 5 mg once daily. Patients then received NIVO 480 mg IV once every 4 weeks. The primary composite end point was partial or complete (tumor) response (CR) or stable disease per RECIST v1.1 without allograft loss at 16W. Patients with progressive disease (PD) could receive IPI 1 mg/kg IV + NIVO 3 mg/kg once every 3 weeks × 4 followed by NIVO. Donor-derived cell-free DNA (dd-cfDNA) levels were measured approximately once every 2 weeks as a potential predictor of allograft rejection.
resultsAmong eight evaluable patients, none met the trial's primary end point. All eight patients experienced PD on NIVO + TACRO + PRED; TRAL occurred in one patient. Six patients then received IPI + NIVO + TACRO + PRED. Best overall responses: two CR (one with TRAL) and four PD (one with TRAL). In total, 7 of 8 pre-NIVO tumor biopsies contained a paucity of infiltrating immune cells. In total, 2 of 5 on-NIVO biopsies demonstrated moderate immune infiltrates; both patients later experienced a CR to IPI + NIVO. In 2 of 3 patients with TRAL, dd-cfDNA elevations occurred 10 and 15 days before increases in serum creatinine.
conclusionIn most KTR with advanced skin cancer, TACRO + PRED provides insufficient allograft protection and compromises immune-mediated tumor regression after administration of NIVO ± IPI. Elevated dd-cfDNA levels can signal treatment-related allograft rejection earlier than rises in serum creatinine.
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