Use of immune checkpoint inhibition and conventional chemotherapy for multiple, concurrent malignancies post-lung transplantation: A case report
Patients with lung transplantation are at a higher risk of malignancy, even compared to the general solid organ transplant community. There is little guidance for the treatment of malignancy in the setting of lung transplantation. This report describes the case of a patient with bilateral lung trans...
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| Format: | Article |
| Language: | English |
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Elsevier
2022-06-01
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| Series: | Current Problems in Cancer: Case Reports |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2666621922000163 |
| _version_ | 1818230742809837568 |
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| author | John P. Claiborne Nooshin Mirkheshti Rima Koka Irina L. Timofte Kevin J. Cullen |
| author_facet | John P. Claiborne Nooshin Mirkheshti Rima Koka Irina L. Timofte Kevin J. Cullen |
| author_sort | John P. Claiborne |
| collection | DOAJ |
| description | Patients with lung transplantation are at a higher risk of malignancy, even compared to the general solid organ transplant community. There is little guidance for the treatment of malignancy in the setting of lung transplantation. This report describes the case of a patient with bilateral lung transplantation who subsequently developed three histologically distinct malignancies. He was treated with adjustment of immunosuppression, conventional chemotherapy, and an immune checkpoint inhibitor. His course was complicated by presumed allograft rejection, responsive to steroid treatment. Follow-up biopsy after rejection treatment was negative, prompting resumption of therapy, including immune checkpoint inhibition. He subsequently died secondary to progressive metastatic disease but, overall, lived 16 months after the diagnoses of metastatic cancer, a significant survival considering the high mortality of patients with lung transplantation and metastatic disease. This is the first report of immune checkpoint inhibition in the setting of multiple malignancies post-lung transplant and the fourth describing immune checkpoint inhibition after lung transplantation, three of which were significant for immune-mediated complications. Incorporation of patients with lung transplantation into clinical trials is necessary to definitively compare safety and efficacy of immune checkpoint inhibition and other agents in this population, which at present is unknown. |
| first_indexed | 2024-12-12T10:39:20Z |
| format | Article |
| id | doaj.art-7947c8b8cf12422ea23bdb567ef0a51a |
| institution | Directory Open Access Journal |
| issn | 2666-6219 |
| language | English |
| last_indexed | 2024-12-12T10:39:20Z |
| publishDate | 2022-06-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Current Problems in Cancer: Case Reports |
| spelling | doaj.art-7947c8b8cf12422ea23bdb567ef0a51a2022-12-22T00:27:05ZengElsevierCurrent Problems in Cancer: Case Reports2666-62192022-06-016100152Use of immune checkpoint inhibition and conventional chemotherapy for multiple, concurrent malignancies post-lung transplantation: A case reportJohn P. Claiborne0Nooshin Mirkheshti1Rima Koka2Irina L. Timofte3Kevin J. Cullen4Department of Internal Medicine, University of Maryland Medical Center, 22 South Greene St., Baltimore, MD 21201, United States; Address Correspondence to John Preston Claiborne, Assistant Instructor, 22 South Greene St., Baltimore, MD 21201.University of Maryland Greenebaum Comprehensive Cancer Center, 22 South Greene St., Baltimore, MD 21201, United StatesDepartment of Pathology, University of Maryland Medical Center, 22 South Greene St., Baltimore, MD 21201, United StatesDivision of Pulmonary and Critical Care Medicine, Department of Internal Medicine, University of Maryland Medical Center, 22 South Greene St., Baltimore, MD 21201. Present address: Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, University of Texas Southwestern, 5323 Harry Hines Blvd. Dallas, TX 75390, United StatesUniversity of Maryland Greenebaum Comprehensive Cancer Center, 22 South Greene St., Baltimore, MD 21201, United StatesPatients with lung transplantation are at a higher risk of malignancy, even compared to the general solid organ transplant community. There is little guidance for the treatment of malignancy in the setting of lung transplantation. This report describes the case of a patient with bilateral lung transplantation who subsequently developed three histologically distinct malignancies. He was treated with adjustment of immunosuppression, conventional chemotherapy, and an immune checkpoint inhibitor. His course was complicated by presumed allograft rejection, responsive to steroid treatment. Follow-up biopsy after rejection treatment was negative, prompting resumption of therapy, including immune checkpoint inhibition. He subsequently died secondary to progressive metastatic disease but, overall, lived 16 months after the diagnoses of metastatic cancer, a significant survival considering the high mortality of patients with lung transplantation and metastatic disease. This is the first report of immune checkpoint inhibition in the setting of multiple malignancies post-lung transplant and the fourth describing immune checkpoint inhibition after lung transplantation, three of which were significant for immune-mediated complications. Incorporation of patients with lung transplantation into clinical trials is necessary to definitively compare safety and efficacy of immune checkpoint inhibition and other agents in this population, which at present is unknown.http://www.sciencedirect.com/science/article/pii/S2666621922000163Immune checkpoint inhibitorsImmunotherapyImmunosuppressionLung transplantationGraft rejection |
| spellingShingle | John P. Claiborne Nooshin Mirkheshti Rima Koka Irina L. Timofte Kevin J. Cullen Use of immune checkpoint inhibition and conventional chemotherapy for multiple, concurrent malignancies post-lung transplantation: A case report Current Problems in Cancer: Case Reports Immune checkpoint inhibitors Immunotherapy Immunosuppression Lung transplantation Graft rejection |
| title | Use of immune checkpoint inhibition and conventional chemotherapy for multiple, concurrent malignancies post-lung transplantation: A case report |
| title_full | Use of immune checkpoint inhibition and conventional chemotherapy for multiple, concurrent malignancies post-lung transplantation: A case report |
| title_fullStr | Use of immune checkpoint inhibition and conventional chemotherapy for multiple, concurrent malignancies post-lung transplantation: A case report |
| title_full_unstemmed | Use of immune checkpoint inhibition and conventional chemotherapy for multiple, concurrent malignancies post-lung transplantation: A case report |
| title_short | Use of immune checkpoint inhibition and conventional chemotherapy for multiple, concurrent malignancies post-lung transplantation: A case report |
| title_sort | use of immune checkpoint inhibition and conventional chemotherapy for multiple concurrent malignancies post lung transplantation a case report |
| topic | Immune checkpoint inhibitors Immunotherapy Immunosuppression Lung transplantation Graft rejection |
| url | http://www.sciencedirect.com/science/article/pii/S2666621922000163 |
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