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Kidney Transplant Recipients: Immunotherapy Strategy for Cutaneous Squamous Cell Carcinoma

By: Joshua D. Madera, MD
Posted: Wednesday, February 7, 2024

For patients with advanced cutaneous squamous cell carcinoma who have a history of solid organ transplantation, the use of a mechanistic target of rapamycin (mTOR) inhibitor plus corticosteroids may prove to be an acceptable immunosuppressive strategy for those receiving immunotherapy with cemiplimab-rwlc, according to a small study published in the Journal of Clinical Oncology. Additional investigative efforts aimed at examining alternative immunosuppression regimens may be warranted to determine the extent of clinical benefit in this patient population, suggested Glenn J. Hanna, MD, of the Dana-Farber Cancer Institute, Boston, and colleagues.

From 2020 to 2023, a total of 12 patients with locoregionally advanced unresectable, incurable, or metastatic cutaneous squamous cell carcinoma were recruited for the study. All patients had received kidney transplants at least 6 months before enrollment. Patients were cross-tapered to an mTOR inhibitor from their current immunosuppressive regimen and prednisone, and they were subsequently treated with intravenous cemiplimab. During treatment, patients were regularly monitored with imaging assessments.

The study findings revealed either a complete or partial response to cemiplimab in 46% of patients. Two of these patients demonstrated evidence of a durable response (beyond 1 year). In addition, no treatment-related evidence of kidney rejection or loss was observed. The median progression-free survival and overall survival were both documented as 22.5 months. Furthermore, 42% of patients reported experiencing treatment-related adverse events. They included metabolic disturbances, diarrhea, and infection. Moreover, during the mTOR inhibitor cross-taper, one patient experienced fatal anaphylaxis and angioedema.

Disclosure: For full disclosures of the study authors, visit

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