The addition of immunotherapy to standard anti-rejection medication could change the lives of thousands of kidney transplant patients with incurable cancer, as new research shows that it can reduce this risk of organ rejection and eliminate cancer in a a quarter of patients.
Conducted by researchers at Royal Adelaide Hospital and the University of South Australia, the world’s first study showed that a dual combination of anti-transplant drugs and immune checkpoint inhibitors * not only reduced rates of 12% organ rejection (40 to 40). 50 percent), but also eradicated cancer cells in 25 percent of patients.
Immune checkpoint inhibitors are drugs that block proteins called checkpoints. These checkpoints help prevent immune responses from becoming too strong, but they can also prevent T cells from killing cancer cells. When these checkpoints are blocked, T cells can kill cancer cells more effectively.
UniSA researcher and kidney specialist at Royal Adelaide Hospital Associate Professor Rob Carroll says these findings are a game changer for kidney transplant patients with incurable cancer.
“Cancer is one of the leading causes of death in kidney transplant recipients, with a cancer rate three times higher in this group than in the general population,” says Professor Carroll.
“The terrible irony is that the immunosuppressants that patients must always take to prevent their immune systems from attacking their transplants are also the drugs that prevent the immune system from being removed from precancerous cells.
“To correct this imbalance, our study tested the effectiveness of keeping reference drugs against rejection (to protect the transplant) and adding inhibitors of the immune checkpoint (to attack cancer).
“Patients responded well with lower organ rejection rates at 12%, compared to previous reports and eliminating cancer cells in 25% of patients.
“It is a massive breakthrough for kidney transplant patients; a new chance at life “.
Published in Lancet Oncology, the study evaluated 22 patients with a kidney transplant and a locally advanced or incurable metastatic cancer that had progressed despite standard first-line antitumor treatment. They kept their standard anti-rejection drugs unchanged and were treated with an immune checkpoint inhibitor, nivolumab.
Notes for editors:
The study was conducted by researchers from: the Central North Adelaide Transplant and Kidney Service; the Royal Adelaide Hospital; the University of South Australia; Chris O’Brien’s Lighthouse; the University of Sydney; the Royal Prince Alfred Hospital; and Monash University.
⁇
Contact for the interview: Associate Professor Rob Carroll E: Robert.Carroll@unisa.edu.au UniSA Media contact: Annabel Mansfield M: +61 0479 182 489 E: Annabel.Mansfield@unisa.edu.au
RAH Contact Media: Abby Bowden M: +61 468 575 280 E: Abby.Bowden@sahealth.sa.gov.au
magazine
The Lancet Oncology
Research method
Experimental study
Research topic
People
Article title
Immune checkpoint inhibitors in kidney transplant recipients: a single-arm, multicenter phase 1 study
IOC statement
MB declares funding for research by Bristol Myers Squibb, AstraZeneca, Merck Sharpe & Dohme, Roche and Amgen; and fees from Amgen, AstraZeneca and Merck Sharpe & Dohme. JRZ declares leadership for the ICON group; shares and other holdings in Biomarin, Opthea, Amarin Corporation, Concert Pharmaceuticals, Frequency Therapeutics, Gilead Sciences, Madrigal Pharmaceuticals, Uniqure, Zogeniz, Orphazyme, Moderna Therapeutics, Twist Bioscience and Novovax; honoraria of Specialized Therapeutics, Merck Serono, Targovax, Halozyme, Gilead Sciences and Deciperha; advisory function consulting for Merck Serono, Targovax, Merck Sharp & Dohme, Halozyme, Liptoek, Specialized Therapeutics, Center for Emerging and Neglected Diseases, Deciphera, Revolution Medicine, FivePHusion, Genor BioPharma, 1Globe Health Institute and Novotech; research funding from Merck Serono, Bristol Myers Squibb, AstraZeneca, Pfizer, IQvia, Mylan, Ipsen, Eisai, Medtronic and MSD Oncology; and accommodation and travel expenses for Merck Serono, AstraZeneca, Merck Sharp & Dohme, Deciphera and Sanofi. All other authors do not declare competing interests.
Disclaimer: AAAS and EurekAlert! is not responsible for the accuracy of news releases published on EurekAlert! by contributing institutions or by the use of any information through the EurekAlert system.