Most kidney transplant patients usually stop taking their immunosuppressive drugs before starting cancer immunotherapy treatment to diminish the chances of their immune systems attacking the transplanted organs. However, a new study has found that combining standard antirejection medication and immune checkpoint inhibitors may benefit kidney transplant patients who suffer from terminal cancer.
Immune checkpoint inhibitors are drugs designed to block checkpoints, which are proteins that prevent immune responses in the body from being too strong. Checkpoints also prevent T-cells from eliminating cancer cells. Blocking these checkpoints allows T-cells to eradicate cancer cells more effectively.
The study’s objective was to look into the risk of allograft rejection with immunotherapy exposure when baseline antirejection drugs were left unchanged. For their study, the researchers carried out a single-arm, multicenter phase I study in three health facilities in Australia. The researchers recruited kidney transplant recipients aged 18 and above who suffered from defined metastatic solid tumors or locally advanced incurable cancer. To be eligible for the study, patients had to have creatinine concentration levels that were no more than 180 mmol/L.
Associate professor Rob Carroll, a renal specialist and researcher at the Royal Adelaide Hospital, stated that this study’s discovery was a massive advancement for patients with terminal cancer who were scheduled for kidney transplants. Carroll explained that cancer was the major cause of death in kidney transplant recipients as the rate of cancer was three times higher in these patients, in comparison to the general population.
He noted that it was ironic that the immunosuppressants prescribed to patients to prevent their immune systems from attacking their transplanted organs were the same drugs that stopped their immune systems from eliminating the precancer cells. To rectify this imbalance, the researchers evaluated the efficacy of adding immune checkpoint inhibitors to attack the cancer while administering baseline antirejection medications to protect the transplant from rejection.
They discovered that this combination decreased the risk of organ rejection and eradicated the cancer in 25% of the patients. In their report, the researchers note that the study demonstrated that adding transplant antirejection drugs to immune checkpoint inhibitors not only eliminated the cancer cells in a quarter of patients but also decreased organ rejection rates to 12% from 45%.
This trial has been completed and is registered with the New Zealand and Australian Clinical Trial register. It was carried out by scientists at the University of South Australia and the Royal Adelaide Hospital. The researchers published their findings in “The Lancet Oncology” journal.
With companies such as Aditxt Inc. (NASDAQ: ADTX) also investing heavily in developing programs that help to retrain the immune system, organ rejection could soon be a thing of the past.
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