Original contributions: Case reportsKidneyRenal Allograft Failure After Ipilimumab Therapy for Metastatic Melanoma: A Case Report and Review of the Literature
Section snippets
Case Report
We report the case of a 40-year-old male transplant recipient who underwent therapy with ipilimumab for metastatic ocular melanoma. At the age of 18 years, he developed chronic renal failure of an unknown aetiology. After a period of 2 years on peritoneal dialysis, he received a living related donor transplant from his mother in March 1994. After transplantation, his creatinine rose on day 5 and he was pre-emptively treated with methylprednisolone; a subsequent transplant biopsy demonstrated no
Discussion
The introduction of immunotherapy against cancer creates a further dimension of complexity, a result of the different adverse effects when compared with traditional treatment options. The CTLA-4 pathway plays a key role in the maintenance of self-tolerance and suppression of the immune response [7]. In the absence of CTLA-4 signaling, there is potentiation of the immune response through lymphocytic proliferation and interleukin production [10], [11]. Antagonizing the CTLA-4 receptor can be
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2020, Lung CancerCitation Excerpt :Besides the possibility of reduced efficacy of immunotherapy in these patients, graft rejection and its consequences according to the type of organ transplanted (kidney rejection might be replaced with dialysis but there is no substitutive therapy for other organs) is the main concern in these patients [49,50]. Babey et al. [51] in a review of the literature identified 17 cases of patients with organ transplantation treated with ICIs (10 kidney, 6 liver, and 1 heart). Only one patient had NSCLC.
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2020, Journal of the American Academy of DermatologyCitation Excerpt :Although physicians are cautious regarding the use of immunotherapies in SOTRs, the majority of deaths in this population occurred due to progression of metastatic cancer. In many of these cases, immunotherapy was not the first-line treatment offered patients (Table I)14-49; this treatment was administered as a salvage therapy, given prior progression of disease. For the subset of patients with kidney allografts, one could argue that in the event immunotherapy produced a favorable response, graft loss can be medically managed with hemodialysis.