• Hannah S Berman, Catherine A Degesys, and Leila Tolaymat.
• From the Department of Dermatology, Mayo Clinic, Jacksonville, Florida.
• South. Med. J. 2023 Feb 1; 116 (2): 220224220-224.

ObjectivesOrgan transplant recipients have an increased risk of skin cancer, but treatment options for metastatic skin cancer are limited because of their immunosuppressed state. We sought to qualify the clinical experience and patient safety of immune checkpoint inhibitors (ICIs) for skin cancer treatment in transplant recipients at one large academic institution.MethodsWe conducted a retrospective chart review including patients who had at least one organ transplant, a diagnosis of skin cancer, and received an ICI to treat their skin cancer.ResultsFour patients met our criteria. Three received an ICI for metastatic melanoma and died secondary to their cancer. One patient, treated for squamous cell carcinoma, had remission of his cancer with ICI treatment. Only one patient had transplant rejection.ConclusionsICIs can be used in organ transplant patients, but the risk of transplant rejection must be carefully discussed because it may be associated with an increased risk of death. A higher risk of rejection exists with anti-programmed cell death 1 and anti-programmed cell death ligand 1 inhibitors.

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