Immunotherapies directed at T-cell activation through antibodies targeting checkpoint proteins, such as programmed cell death 1 (PD1), are rapidly becoming the new standard of care in the treatment of several malignancies. Cemiplimab is a monoclonal antibody targeting PD1 that has recently emerged as a highly active treatment for locally advanced and metastatic cutaneous squamous cell carcinoma (CSCC). Patients who have received an organ transplant (OTRs) have been traditionally excluded from clinical trials with checkpoint inhibitors (CIs), given concerns for organ rejection. Renal transplant recipients (RTRs) are more likely to develop cancers than the general population, and skin cancers are among the most frequent malignancies. We report the case of a 72-year-old man with a history of a kidney transplant who presented with a rapidly growing, locally advanced squamous cell carcinoma (SCC) of the scalp that recurred within four weeks from surgical resection. The patient was able to safely receive ten cycles of cemiplimab so far with significant clinical benefit, and no issues with his kidney function, while continuing immunosuppression with low dose prednisone alone. An ongoing clinical trial (NCT04339062) is further exploring the safety of CIs in patients with metastatic CSCC who have previously received allogeneic hematopoietic stem cell transplant or a kidney transplant.

中文翻译：

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Cemiplimab 对患有局部晚期头皮鳞状细胞癌的肾移植患者的安全给药

通过靶向检查点蛋白（如程序性细胞死亡 1 (PD1)）的抗体激活 T 细胞的免疫疗法正迅速成为治疗多种恶性肿瘤的新标准。Cemiplimab 是一种靶向 PD1 的单克隆抗体，最近已成为局部晚期和转移性皮肤鳞状细胞癌 (CSCC) 的高效治疗方法。由于担心器官排斥，接受器官移植 (OTR) 的患者传统上被排除在检查点抑制剂 (CI) 的临床试验之外。肾移植受者 (RTR) 比一般人群更容易患上癌症，皮肤癌是最常见的恶性肿瘤之一。我们报告了一个有肾移植史的 72 岁男性的病例，他出现了快速增长，手术切除后 4 周内复发的头皮局部晚期鳞状细胞癌 (SCC)。到目前为止，该患者能够安全地接受 10 个周期的 cemiplimab，具有显着的临床益处，并且他的肾功能没有问题，同时继续单独使用低剂量泼尼松进行免疫抑制。一项正在进行的临床试验 (NCT04339062) 正在进一步探索 CIs 在先前接受过异基因造血干细胞移植或肾移植的转移性 CSCC 患者中的安全性。同时单独使用低剂量泼尼松继续免疫抑制。一项正在进行的临床试验 (NCT04339062) 正在进一步探索 CIs 在先前接受过异基因造血干细胞移植或肾移植的转移性 CSCC 患者中的安全性。同时单独使用低剂量泼尼松继续免疫抑制。一项正在进行的临床试验 (NCT04339062) 正在进一步探索 CIs 在先前接受过异基因造血干细胞移植或肾移植的转移性 CSCC 患者中的安全性。