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Immune Checkpoint Inhibitors in Kidney Transplant Recipients: A French Multicenter Retrospective Cohort Study.
Tristan Legris1, Marion Sallée1, Xavier Charmetant2
1Department of Nephrology and Kidney Transplantation, APHM, Conception University Hospital, Marseille, France.
Transplantation Direct
|August 4, 2025
Summary
Immune checkpoint inhibitors (ICIs) show promise for kidney transplant recipients (KTRs) with advanced cancers, offering a 38% response rate. This therapy presents a viable option with a manageable risk of graft loss.
Area of Science:
- Oncology
- Nephrology
- Immunology
Background:
- Kidney transplant recipients (KTRs) face a higher risk of developing cancer.
- Limited data exist on the safety and effectiveness of immune checkpoint inhibitors (ICIs) in KTRs.
- This study reassesses the benefit-risk profile of ICI therapy in KTRs.
Purpose of the Study:
- To evaluate the efficacy and safety of immune checkpoint inhibitors (ICIs) in kidney transplant recipients (KTRs).
- To determine the cancer response, acute rejection (AR) incidence, and survival outcomes in KTRs treated with ICIs.
Main Methods:
- Retrospective cohort study across 6 transplant centers.
- Analysis of KTRs treated with ICIs for advanced or metastatic cancer from 2015 to 2024.
- Evaluation of cancer response, AR, graft survival, and patient survival.
Main Results:
- 38% objective response rate observed in 34 KTRs, with median progression-free survival of 5.5 months.
- Acute rejection (AR) occurred in 26.5% of patients, primarily T-cell mediated.
- Favorable outcomes (tumor response without graft loss) seen in 29% of patients; 15% experienced graft loss.
Conclusions:
- ICI therapy is a viable option for KTRs with poor-prognosis cancers.
- Observed tumor response rate of 38% and a lower graft loss incidence (15%) than previously reported.
- Further prospective studies are recommended to optimize ICI use in KTRs.
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