Acute renal transplant rejection following nivolumab therapy for metastatic melanoma

Brandon Tan (Lead / Corresponding author), Mark Baxter, Richard Casasola

Research output: Contribution to journalArticlepeer-review

Abstract

Cancers can develop the ability to evade immune recognition and destruction. Immune checkpoint inhibitors (ICIs) are drugs targeting these immune evasion mechanisms. ICIs have significantly improved outcomes in several cancers including metastatic melanoma. However, data on toxicities associated with allograft transplant recipients receiving ICI is limited. We describe a case of a 71-year-old woman who was diagnosed with metastatic melanoma 13 years after renal transplantation. She was commenced on the ICI nivolumab. She developed acute renal transplant rejection 15 days after administration of the first dose. She continues on haemodialysis but has demonstrated complete oncological response. This case demonstrates the risk of acute renal transplant rejection versus improved oncological outcomes. Patients and clinicians must consider this balance when initiating ICI therapy in allograft transplant recipients. Patients should be fully consented of the potential consequences of acute renal transplant rejection including lifelong dialysis.

Original languageEnglish
Article numbere238037
Number of pages6
JournalBMJ Case Reports
Volume14
Issue number2
Early online date8 Feb 2021
DOIs
Publication statusPublished - Feb 2021

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