Article Text

Download PDFPDF
Immune checkpoint inhibitors in the management of malignancies in transplant recipients
  1. Dileep Kumar Reddy Regalla1,
  2. Grant R Williams2,
  3. Ravi kumar Paluri2
  1. 1 Internal Medicine, University of Alabama at Birmingham Hospital, Birmingham, Alabama, USA
  2. 2 Hematology-Oncology, University of Alabama at Birmingham Hospital, Birmingham, Alabama, USA
  1. Correspondence to Dr Ravi kumar Paluri, Hematology-Oncology, University of Alabama at Birmingham Hospital, Birmingham, AL 35233, USA; rpaluri{at}


Cancer immunotherapy, an area of active research, has thus far yielded several exciting breakthroughs in cancer treatment strategies. So far, immune checkpoint inhibitors have been the most promising method of cancer immunotherapy. CTLA-4, PD-1 and PD-L1 are the immune checkpoint molecules against which monoclonal antibodies act against and revolutionised the treatment of several malignancies. However, it is still unclear whether using these monoclonal antibodies in patients with malignancy and a history of transplant is as beneficial as in patients without a history of transplantation. The reason being, with the therapeutic benefit, also comes the inherent disadvantage of transplant rejection because of the activation of T-cells against donor antigens. So, transplant-related complications limit the usage of the checkpoint blockade therapy to treat malignancies. Here, we review the data published in this context and suggest optimal approaches to using the currently available repertoire of immunotherapies.

  • immune checkpoint inhibitors
  • solid organ transplant
  • malignancy
  • monoclonal antibodies
  • CTLA-4
  • PD-1
View Full Text

Statistics from


  • Contributors This work was carried out in collaboration between all authors. DKRR gathered the literature data and wrote the initial manuscript draft. RP put forward with the concept, reviewed and edited the final draft. GRW reviewed and proofread the manuscript and also reviewed the quoted references.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent Not required.

  • Provenance and peer review Not commissioned; externally peer reviewed.

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.