Transplant recipients have a significantly higher risk for developing melanoma than
the general population [
[1]
]. Immune checkpoint inhibitors (ICIs) have recently proved efficacy for the treatment
of metastatic melanoma by increasing progression-free and overall survival [
[2]
]. However, their efficacy and toxicity profiles are not well described in the transplant
recipient population, systematically excluded from clinical trials. Indeed, allograft
rejection is a most feared adverse effect in transplanted patients [
[3]
], and programmed death 1 (PD-1) blockade in solid organ transplantation (SOT) may
even be associated with a higher risk of rejection than cytotoxic T-lymphocyte–associated
antigen (CTLA-4) inhibitors.Abbreviations:
B-RAF (B-raf protooncogene), CMV (Cytomegalovirus), CTLA-4 (Cytotoxic T-Lymphocyte–Associated Antigen 4), ICI (Immune Checkpoint Inhibitor), INF-γ (Interferon-γ), PD-1 (Programmed Death 1), PD-L (Programmed Death Ligand), SOT (Solid Organ Transplantation), TNF-α (Tumor Necrosis Factor-α)To read this article in full you will need to make a payment
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References
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- CMV infection in the donor and increased kidney graft loss: impact of full HLA-I mismatch and posttransplantation CD8(+) cell reduction.Am J Transplant. 2013; 13: 2119-2129https://doi.org/10.1111/ajt.12298
- Longitudinal studies of clonally expanded CD8 T cells reveal a repertoire shrinkage predicting mortality and an increased number of dysfunctional cytomegalovirus-specific T cells in the very elderly.J Immunol. 2006; 176: 2645-2653https://doi.org/10.4049/jimmunol.176.4.2645
- PD-1 expression and IL-2 loss of cytomegalovirus-specific T cells correlates with viremia and reversible functional anergy.Am J Transplant. 2008; 8: 1486-1497https://doi.org/10.1111/j.1600-6143.2008.02279.x
Article info
Publication history
Published online: February 04, 2019
Accepted:
December 28,
2018
Received in revised form:
December 17,
2018
Received:
November 7,
2018
Identification
Copyright
© 2019 Elsevier Ltd. All rights reserved.
