Treatment with programmed-death-1 inhibitors for non-melanoma skin cancer among immunocompromised patients with subgroup analysis of solid organ transplant patients.

IF 4.8 2区医学 Q1 ONCOLOGY

Oncologist Pub Date : 2025-02-06 DOI:10.1093/oncolo/oyaf022

Eyal Yosefof, Nofar Edri, Idan Ben-Nachum, Dan Yaniv, Aviram Mizrachi, Nethanel Asher, Naomi Ben-Dor, Avital Ben-Artzi, Itamar Averbuch, Noga Kurman

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引用次数: 0

Abstract

Background: Programmed-cell death protein 1 (PD-1) inhibitors have emerged as a standard of care treatment among advanced-stage or metastatic cutaneous squamous cell carcinoma (cSCC). Immune-compromised patients and particularly solid organ transplant recipients (SOTRs) are considered at high risk for cSCC. When treated with PD-1 inhibitors, the possibility of organ rejection, autoimmune flare, or insufficient response to treatment is feared. As these patients were excluded from past prospective clinical trials, we aim to describe our institute's experience regarding these patients.

Methods: A retrospective analysis was conducted on cSCC patients treated with PD-1 inhibitors. Comparisons were made between immune-compromised and immune-competent groups, with a subgroup analysis of SOTR.

Results: The study cohort comprised of 133 patients, including 97.8% receiving Cemiplimab with a mean age of 77.2 ± 11.7 years. Immune-compromised patients constituted 26.9% (n = 35) of the cohort, including 10 SOTR (all kidney transplant recipients). Objective response rates (ORRs) and disease control rates (DCR) were comparable between immunocompetent and immunosuppressed patients receiving Cemiplimab (ORR: 76.8% vs 62.9%, P = .12; DCR: 81.1% vs 68.6%, P = .13). SOTR demonstrated an 80% ORR and DCR. Progression-free survival was comparable across all groups. Toxicity rates were similar between immunosuppressed and immunocompetent subgroups (68.6% vs 62.1%, P = .5). Two OTRs (20%) experienced acute graft rejection.

Conclusions: PD-1 inhibitors demonstrate efficacy and safety in immunosuppressed cSCC patients. While effective in SOTR, treatment requires multidisciplinary management due to the potential risk of organ rejection. These findings provide valuable insights into this understudied population and support the use of PD-1 inhibitors in immunosuppressed patients with advanced cSCC.

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程序性死亡-1抑制剂治疗实体器官移植患者免疫功能低下患者的非黑色素瘤皮肤癌亚组分析

背景：程序性细胞死亡蛋白1 （PD-1）抑制剂已成为晚期或转移性皮肤鳞状细胞癌（cSCC）的标准护理治疗。免疫功能低下的患者，特别是实体器官移植接受者（SOTRs）被认为是cSCC的高风险人群。当使用PD-1抑制剂治疗时，可能会出现器官排斥、自身免疫耀斑或对治疗反应不足。由于这些患者被排除在过去的前瞻性临床试验之外，我们的目的是描述我们研究所对这些患者的经验。方法：对使用PD-1抑制剂治疗的cSCC患者进行回顾性分析。比较免疫功能低下组和免疫功能正常组，并对SOTR进行亚组分析。结果：研究队列包括133例患者，其中97.8%的患者接受了塞米普利单抗治疗，平均年龄为77.2±11.7岁。免疫功能低下患者占队列的26.9% (n = 35)，其中包括10名SOTR（所有肾移植接受者）。免疫功能正常患者和免疫抑制患者的客观缓解率（ORR）和疾病控制率（DCR）具有可比性(ORR: 76.8% vs 62.9%, P = 0.12；DCR: 81.1% vs 68.6%, P = 0.13)。SOTR显示80%的ORR和DCR。所有组的无进展生存期具有可比性。免疫抑制亚组和免疫正常亚组的毒副率相似（68.6% vs 62.1%, P = 0.5）。2例OTRs（20%）出现急性移植排斥反应。结论：PD-1抑制剂对免疫抑制的cSCC患者具有疗效和安全性。虽然对SOTR有效，但由于器官排斥的潜在风险，治疗需要多学科管理。这些发现为这一未被充分研究的人群提供了有价值的见解，并支持在免疫抑制的晚期cSCC患者中使用PD-1抑制剂。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Oncologist 医学-肿瘤学

CiteScore

10.40

自引率

3.40%

发文量

309

审稿时长

3-8 weeks

期刊介绍： The Oncologist® is dedicated to translating the latest research developments into the best multidimensional care for cancer patients. Thus, The Oncologist is committed to helping physicians excel in this ever-expanding environment through the publication of timely reviews, original studies, and commentaries on important developments. We believe that the practice of oncology requires both an understanding of a range of disciplines encompassing basic science related to cancer, translational research, and clinical practice, but also the socioeconomic and psychosocial factors that determine access to care and quality of life and function following cancer treatment.