Merkel Cell Carcinoma in Solid Organ Transplant Recipients: Prognosis and Response to Immunotherapy

Rákkutatás · Merkel cell carcinoma

Eight kidney transplant patients received immunotherapy. Five (63%) saw their cancer shrink or disappear.

The study examined 1,214 Merkel cell carcinoma (MCC) patients, including 37 solid organ transplant recipients (SOTR) and 1,177 immunocompetent controls. SOTR were more likely to present with advanced disease (76% vs. 51%) and had worse outcomes, including higher rates of disease progression (adjusted hazard ratio 2.3), MCC‑specific mortality (3.0), and overall mortality (3.9). Median time to death due to MCC was 2.7 years for SOTR and 24% died within one year of diagnosis compared to 4% in controls. Eight kidney transplant recipients received anti‑PD‑(L)1 therapy; 5 (63%) achieved an objective response, but 2 (29%) experienced irreversible graft failure.

Patients with solid organ transplants are immunosuppressed, placing them at higher risk for aggressive Merkel cell carcinoma. The study indicates that while anti‑PD‑(L)1 immunotherapy can produce objective responses in kidney transplant recipients, it also carries a significant risk of graft failure, underscoring the need for careful patient selection and shared decision‑making.

Bizonyítékszint: Korai humán adat. Kis vagy feltáró emberi adat.

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