The efficacy of immune checkpoint inhibitors (ICIs) in kidney transplant recipients is not well understood, as the results are confounded by allograft rejection observed following suspension of immunosuppressive therapy. In a multicentre, single-arm study published in The Lancet Oncology, 22 kidney transplant recipients with various solid tumours received nivolumab. The primary outcome was a combination of irretrievable allograft rejection and no evidence of tumour response, which, at a median follow-up time of 28 months, was not observed in any patient. Only minor treatment-related adverse events and no treatment-related deaths were reported. Thus, baseline immunosuppressive treatment in patients with cancer who received a kidney transplant reduces the risk of allograft rejection without affecting the efficacy of ICIs, supporting the inclusion of these patients in prospective trials of ICIs.

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