Objective:

To identify key factors that could improve outcomes for cancer patients treated with immune checkpoint inhibitors (ICIs) before or after a solid-organ transplant.

Key Findings:

• Rejection rates were highest among kidney transplant recipients (46.3%), followed by heart (40.0%) and liver (26.9%).
• Patients receiving anti-PD1 therapy had the highest rejection rates (40.6%).
• Rejection rates were higher for post-transplant ICI therapy (40.9%) compared to pre-transplant (25.9%).
• Overall response rates varied by ICI type, with anti-PDL1 showing the highest response (72.7%).
• Patients with cutaneous squamous cell carcinoma had the highest overall response rate (49.1%).

Interpretation:

ICI therapy in solid-organ transplant patients presents a high-risk yet promising avenue for treatment, necessitating further research to optimize protocols and predict outcomes effectively.

Limitations:

• The study is based on a limited number of transplant patients (331).
• Variability in response rates and rejection rates may be influenced by factors such as patient demographics and tumor characteristics that were not fully explored in the analysis.

Conclusion:

Further research is essential to develop safe treatment protocols and expand access to immunotherapies for transplant recipients, particularly in light of the high-risk nature of this patient population.