AUTHOR=Bolufer Mónica , Soler Jordi , Molina María , Taco Omar , Vila Anna , Macía Manuel 

TITLE=Immunotherapy for Cancer in Kidney Transplant Patients: A Difficult Balance Between Risks and Benefits

JOURNAL=Transplant International

VOLUME=Volume 37 - 2024

YEAR=2024

URL=https://www.frontierspartnerships.org/journals/transplant-international/articles/10.3389/ti.2024.13204

DOI=10.3389/ti.2024.13204

ISSN=1432-2277

ABSTRACT=Cancer is one of the main causes of morbidity and mortality in kidney transplant patients. Unfortunately, in this population, the use of new oncospecific therapies such as Immune checkpoint inhibitors (ICPI) presents, in retrospective studies, rejection rates of up to 40%. The most significant challenge is to keep the patient in a delicate immunologic equilibrium in which, while antitumor therapy defeats cancer the graft is safely protected from rejection.
Recent clinical trials with ICPI have included kidney transplant recipients (KTRs) and the results advocate for a paradigm shift in the management of basal immunosuppression. This suggests avoiding a downward adjustment or, even better, making this adjustment "dynamic”.  This review summarizes the latest scientific evidence available in kidney transplantation on ICPI treatment: case series, prospective studies, histopathological diagnosis, immunosuppression regimens and new biomarkers. This article will provide the latest information on this specific field, enabling nephrologist them to gain valuable knowledge and to be aware of new approaches to immunosuppression management in kidney transplant patients.