Anti-PD-1 immunotherapy for the treatment of metastatic urothelial carcinoma in a kidney transplant recipient: a case report.
Humans
Kidney Transplantation
Aged
Female
Antibodies, Monoclonal, Humanized
/ therapeutic use
Immune Checkpoint Inhibitors
/ therapeutic use
Carcinoma, Transitional Cell
/ drug therapy
Urinary Bladder Neoplasms
/ drug therapy
Kidney Neoplasms
/ drug therapy
Programmed Cell Death 1 Receptor
/ antagonists & inhibitors
Immunotherapy
Urologic Neoplasms
/ drug therapy
Case report
Immune checkpoint inhibitor (ICI)
Kidney transplant
Metastatic urothelial carcinoma (mUC)
Partial response
Tislelizumab
Journal
BMC nephrology
ISSN: 1471-2369
Titre abrégé: BMC Nephrol
Pays: England
ID NLM: 100967793
Informations de publication
Date de publication:
31 Oct 2024
31 Oct 2024
Historique:
received:
11
07
2024
accepted:
16
10
2024
medline:
1
11
2024
pubmed:
1
11
2024
entrez:
1
11
2024
Statut:
epublish
Résumé
Immune checkpoint inhibitor (ICI) therapy has been widely investigated in urothelial carcinoma; however, the utility of ICI therapy in the treatment of organ transplant recipients with metastatic urothelial carcinoma (mUC) is unclear. We herein report the first case of a first-line anti-programmed cell death-1 (anti-PD-1) monotherapy for a kidney transplant patient with mUC. A 71-year-old woman who received a kidney transplant in 2003 was diagnosed with urothelial carcinoma in 2018. After operation of the tumor, the patient developed local recurrence at the site of the right kidney and bladder and multiple distant metastases in May 2020. Considering the intolerance of chemotherapy and high tumor mutation burden, we administered the anti-PD-1 agent tislelizumab (200 mg every three weeks). Partial response was achieved after two cycles of therapy and sustained until 18th cycles. There were no signs of kidney graft rejection. The immunotherapy was temporarily stopped after the 18th course because of a suspicious immune-related pneumonitis and was continued in December 2021. This case demonstrates the feasibility of safely achieving stable cancer control in a kidney transplant patient with mUC without encountering graft rejection by using single-agent anti-PD-1 treatment.
Sections du résumé
BACKGROUND
BACKGROUND
Immune checkpoint inhibitor (ICI) therapy has been widely investigated in urothelial carcinoma; however, the utility of ICI therapy in the treatment of organ transplant recipients with metastatic urothelial carcinoma (mUC) is unclear. We herein report the first case of a first-line anti-programmed cell death-1 (anti-PD-1) monotherapy for a kidney transplant patient with mUC.
CASE PRESENTATION
METHODS
A 71-year-old woman who received a kidney transplant in 2003 was diagnosed with urothelial carcinoma in 2018. After operation of the tumor, the patient developed local recurrence at the site of the right kidney and bladder and multiple distant metastases in May 2020. Considering the intolerance of chemotherapy and high tumor mutation burden, we administered the anti-PD-1 agent tislelizumab (200 mg every three weeks). Partial response was achieved after two cycles of therapy and sustained until 18th cycles. There were no signs of kidney graft rejection. The immunotherapy was temporarily stopped after the 18th course because of a suspicious immune-related pneumonitis and was continued in December 2021.
CONCLUSIONS
CONCLUSIONS
This case demonstrates the feasibility of safely achieving stable cancer control in a kidney transplant patient with mUC without encountering graft rejection by using single-agent anti-PD-1 treatment.
Identifiants
pubmed: 39482589
doi: 10.1186/s12882-024-03825-2
pii: 10.1186/s12882-024-03825-2
doi:
Substances chimiques
Antibodies, Monoclonal, Humanized
0
Immune Checkpoint Inhibitors
0
tislelizumab
0KVO411B3N
Programmed Cell Death 1 Receptor
0
Types de publication
Case Reports
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
390Subventions
Organisme : National High Level Hospital Clinical Research Funding
ID : 2022-PUMCH-A-248
Organisme : National High Level Hospital Clinical Research Funding
ID : 2022-PUMCH-A-248
Informations de copyright
© 2024. The Author(s).
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