Safe Administration of Cemiplimab to a Kidney Transplant Patient with Locally Advanced Squamous Cell Carcinoma of the Scalp

Luca Paoluzzi, Thomas J Ow, Luca Paoluzzi, Thomas J Ow

Abstract

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.

Keywords: PD1; cemiplimab; checkpoint inhibitor; cutaneous squamous cell carcinoma; kidney transplant.

Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Representative pre-treatment, post-contrast, T1-weighted, sagittal MRI images (A) and fused PET-CT images (B) show disease extension predominantly from the vertex scalp to the left lateral temple region.
Figure 2
Figure 2
(A) Multiple nodules consistent with cutaneous squamous cell carcinoma on the left temporal area before starting cemiplimab; (B) tumor regression after three cycles of cemiplimab; (C) response after a total of 10 cycles of cemiplimab.

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Source: PubMed

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