Immune Checkpoint Inhibitors in Heart or Lung Transplantation: Early Results from a Registry Initiative

The immune system uses checkpoints (molecules on immune cells required to activate immune responses) to distinguish normal from foreign cells. Certain cancer cells sequester these checkpoint locations to avoid being targeted, which permits cancer proliferation. Conversely, immunotherapy can harness the immune system to fight cancer. There has been rapid growth in immunotherapy development and applications within oncology. Drugs called immune checkpoint inhibitors (ICIs) are novel therapeutics that enhance survival in malignancies resistant to conventional therapy. 1 Postow MA Callahan MK Wolchok JD Immune checkpoint blockade in cancer therapy. J Clin Oncol. 2015; 33: 1974-1982 Crossref PubMed Scopus (1820) Google Scholar ICIs typically alter the effects of costimulatory signaling molecules on T lymphocytes and antigen-presenting cells, and inhibition of signaling at these immune checkpoints augments intrinsic immune response against cancer cells including renal cell carcinoma, lung cancer, melanoma, lymphoma, and others. However, ICIs are associated with immune-related adverse events, including myocarditis, myositis, endocrinopathies, pneumonitis, and vasculitis, and impact almost any organ system. 2 Brahmer JR Lacchetti C Thompson JA Management of immune-related adverse events in patients treated with immune checkpoint inhibitor therapy: American Society of Clinical Oncology clinical practice guideline summary. J Oncol Pract. 2018; 14: 247-249 Crossref PubMed Scopus (159) Google Scholar