Immune Checkpoint Inhibitors and the Risk of Allograft Rejection: A Comprehensive Analysis on an Emerging Issue

Conclusion.The use of agents that act on the PD‐L1 pathway are contraindicated in the face of solid organ allografts because of unacceptably high rates of irreversible allograft rejection. It appears that the use of ipilimumab may be tolerated as the mechanism is different from that of the PD‐L1 agents.Implications for Practice.Transplant rejection is a complex process that puts stress on patients and their families and can lead to tragic results. Significant advancements in the field of immunosuppression have led to the engenderment of agents devised to extend the survival of transplant recipients. The advent of immunomodulators in cancer therapy has been paradigm‐shifting; however, because of their mechanism of action, their use must be carefully considered in patients with allografts and concomitant cancer. It appears that ipilimumab can be administered safely in these patients but that agents acting on the programmed death‐ligand 1 pathway are contraindicated because of high rates of irreversible rejection.
Source: The Oncologist - Category: Cancer & Oncology Authors: Tags: Hepatobiliary, Lung Cancer, Melanoma and Cutaneous Malignancies Immuno ‐ Oncology Source Type: research