Oops, you're using an old version of your browser so some of the features on this page may not be displaying properly.

MINIMAL Requirements: Google Chrome 24+Mozilla Firefox 20+Internet Explorer 11Opera 15–18Apple Safari 7SeaMonkey 2.15-2.23

Poster display session: Biomarkers, Gynaecological cancers, Haematological malignancies, Immunotherapy of cancer, New diagnostic tools, NSCLC - early stage, locally advanced & metastatic, SCLC, Thoracic malignancies, Translational research

4019 - PD-1 blockade in renal transplant patients with poor prognosis cancer and minimizing risk of organ rejection using comprehensive immune monitoring and screening techniques – a safety study

Date

20 Oct 2018

Session

Poster display session: Biomarkers, Gynaecological cancers, Haematological malignancies, Immunotherapy of cancer, New diagnostic tools, NSCLC - early stage, locally advanced & metastatic, SCLC, Thoracic malignancies, Translational research

Topics

Translational Research

Tumour Site

Presenters

Robert Carroll

Citation

Annals of Oncology (2018) 29 (suppl_8): viii400-viii441. 10.1093/annonc/mdy288

Authors

R. Carroll1, J.R. Zalcberg2, H. Tang3

Author affiliations

  • 1 Central Northern Adelaide Renal And Transplant Service, Royal Adelaide Hospital RAH Cancer Centre, 5000 - Adelaide/AU
  • 2 Department Of Medical Oncology, Alfred Hospital, 3004 - Melbourne/AU
  • 3 Oncology, Royal Adelaide Hospital, SA - Adelaide/AU
More

Resources

Abstract 4019

Background

Renal transplant patients have been excluded from studies involving immune checkpoint inhibitors, notwithstanding the fact that these patients develop many of the tumour types that are known to respond to such therapy, for fear of such approaches inducing organ rejection. At the time of initiation of this safety trial there had been 9 case reports of checkpoint inhibitors in organ transplant patients. 4 patients suffered fulminant transplant organ failure. In all of these cases there was prior major reduction in standard immunosuppressive medications.

Methods

Renal transplant and incurable locally advanced or metastatic cancer that has progressed despite first-line standard anti-tumour treatment or defined metastatic solid tumours, will be enrolled onto a Phase 1 trial. Patients will receive Nivolumab as per approved label. Patients are closely monitored for signs of early rejection and for evidence of safety/toxicity and any anti-tumour effect. Standard inclusion/exclusion criteria for oncological trials were used with the addition of the following: serum creatinine <180 umol/l; absence of Human Leukocyte Antigen (HLA) donor specific antibodies; patients willing to accept potential development of renal transplant failure. All patients were counselled by both a transplant physician and oncologist before signing an ethically approved patient information sheet. Patients were allowed to have minimization of immunosuppression but no medication was completely stopped.

Results

Four patients with metastatic cancer (renal cell, melanoma, SCC head and neck, bladder) were treated with 1, 2, 3 and 9 infusions of nivolumab. One patient has a sustained partial response (after 9 infusions) of their tumour but suffered likely interstitial nephritis which resolved with oral steroid. 3 patients died of progressive cancer after 1,2 and 3 cycles but did not suffer any rejection episodes.

Conclusions

Selected renal transplant patients on low dose immunosuppressive regimens, without significant donor specific allo antibodies, can be treated with nivolumab without rejection episodes and some can have sustained anti tumour responses.

Clinical trial identification

Legal entity responsible for the study

Royal Adelaide Hospital.

Funding

Bristol Myers Squibb.

Editorial Acknowledgement

Disclosure

All authors have declared no conflicts of interest.

This site uses cookies. Some of these cookies are essential, while others help us improve your experience by providing insights into how the site is being used.

For more detailed information on the cookies we use, please check our Privacy Policy.

Customise settings
  • Necessary cookies enable core functionality. The website cannot function properly without these cookies, and you can only disable them by changing your browser preferences.