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Nonmelanoma Skin Cancer Studies / Renal Cell Carcinoma Treatment · Journal article
Journal of Onco-nephrology · September 7, 2026
Early or partial results. Treat as a signal, not a conclusion.
This is a single case report documenting tolerance of Cemiplimab (anti-PD-1) in a stage IV cSCC patient with a 35-year history of sequential kidney transplants, in whom acute kidney injury was attributed to atrial flutter and hypotension rather than graft rejection. The report suggests that individualised diagnostic evaluation may prevent premature discontinuation of cancer therapy in transplant patients, but provides no comparative evidence of safety or efficacy.
Single case report. One patient with stage IV cutaneous squamous cell carcinoma and sequential kidney transplant history.. Intervention: Cemiplimab (anti-PD-1 immune checkpoint inhibitor).
Patient with stage IV cSCC and two sequential kidney transplants tolerated Cemiplimab without ICI-mediated rejection despite reported transplant rejection rates as high as 40% after ICI exposure Acute kidney injury occurred but was attributed to acute tubular necrosis secondary to atrial flutter with hypotension, not immune rejection Patient tested negative for donor-specific antibodies during the AKI episode
Safety was not reported in the material analysed. Check the source before drawing any conclusion about harm.
This case suggests that acute kidney injury in transplant patients receiving ICI may not always reflect graft rejection, warranting thorough aetiological investigation before discontinuing cancer therapy. However, the report is a single case and cannot establish safety or efficacy; clinical decisions should not be based on this case alone.
Single case report with no control group, describing tolerance of anti-PD-1 therapy in an unusual patient population; raises a question about feasibility rather than establishing efficacy or safety.
As stated by the source record.
Quoted from the source exactly as published.
This case suggests that acute kidney injury in transplant patients receiving ICI may not always reflect graft rejection, warranting thorough aetiological investigation before discontinuing cancer therapy. However, the report is a single case and cannot establish safety or efficacy; clinical decisions should not be based on this case alone.
Graded across the dimensions that decide whether you should act, each from what the source actually supports. There is no single score, and where a dimension was not assessed it says so.
Introduction: A cutaneous squamous cell carcinoma (cSCC) stage IV patient with a history of sequential kidney transplants was administered Cemiplimab (anti-PD-1) to treat his advanced cancer. The patient experienced an acute kidney injury (AKI) following initiation of Cemiplimab. The etiology of the AKI was acute tubular necrosis (ATN) due to atrial flutter with associated hypotension. Case Description: Kidney transplant rejection has been reported to be as high as 40% after exposure to immune checkpoint inhibitors; in this case, clinicians may prematurely discontinue immune checkpoint inhibitors (ICI) such as Cemiplimab in fear of graft loss. This case highlights that an individualized and comprehensive approach to finding the etiology of the AKI in patients treated with ICI is valuable for reducing the chance that stage IV cancer patients are taken off life-saving cancer treatment. The patient tested negative for donor specific antibodies during AKI although the patient has had two separate kidney transplants. Conclusions: Despite a significantly increased risk of alloimmunization, transplant patients with two separate kidney transplants should be given the opportunity to receive ICI therapy through an individualized patient outlook. To our knowledge, this case marks the first use of ICI in a patient with over 35 years of kidney transplant history and two sequential kidney transplants that did not result in ICI-mediated rejection.
Taken from the source record, never inferred. Follow any of these and new work involving them reaches your briefing.