Successful Shrinkage of a Giant Cutaneous Squamous Cell Carcinoma with Immunotherapy in a Kidney Transplant Recipient

Exp Clin Transplant. 2023 Jun;21(6):534-536. doi: 10.6002/ect.2023.0018.

Abstract

A 56-year-old male living donor kidney transplant recipient presented with a giant cutaneous squamous cell carcinoma in his right parotid region. Programmed radiotherapy had been previously terminated due to lesion ulceration and bleeding. He was characterized as a terminal case. We applied cemiplimab, which is an immune checkpoint inhibitor against the pro-grammed cell death receptor PD-1. After 6 months, the cutaneous squamous cell carcinoma had shrunk and had stopped bleeding. The patient was treated with methylprednisolone, cyclosporine, and mycophenolate mofetil during this period. He had 2 rejection episodes defined as doubling baseline serum creatinine with no other explanation. Both episodes were successfully treated with intravenous methylprednisolone, while immunotherapy was postponed for 10 days. In both cases, serum creatinine returned to baseline within 1 week. Immune checkpoint inhibitors are indicated for invasive cutaneous squamous cell carcinoma therapy, and the risk of acute rejection should not prevent the use of these agents in kidney transplant recipients, because immune checkpoint inhibitors may enhance the quantity and quality of life of such patients.

Publication types

  • Case Reports

MeSH terms

  • Carcinoma, Squamous Cell* / therapy
  • Creatinine
  • Graft Rejection / prevention & control
  • Humans
  • Immune Checkpoint Inhibitors / therapeutic use
  • Immunotherapy / adverse effects
  • Kidney Transplantation* / adverse effects
  • Male
  • Methylprednisolone / therapeutic use
  • Middle Aged
  • Quality of Life
  • Skin Neoplasms* / drug therapy
  • Skin Neoplasms* / pathology

Substances

  • Immune Checkpoint Inhibitors
  • Creatinine
  • Methylprednisolone