The Know-How Post-Transplant Skin Cancer for Immunotherapy and Target Therapies

Background: Kidney transplant recipients are increasing, as is their life expectancy. Due to immunosuppression, skin cancers are the neoplasms more common in this population. Summary: Cancer immunotherapy is the choice treatment for squamous cell non-melanoma skin cancer (NMSC) patients who are not candidates for local therapies such as radiotherapy and surgery. For basal cell carcinomas requiring systemic therapies, hedgehog inhibitors (HHis) are necessary. Traditionally, special populations, such as solid organ transplant recipients, were excluded from clinical studies. We reviewed the literature on immunotherapy and HHis for NMSC in this specific population. Key messages: Immunotherapy may be administered to selected patients following a thorough multidisciplinary evaluation. Factors such as prior episodes of rejection, high proteinuria, and elevated anti-donor antibody levels should be considered relative contraindications. Similarly, HHis may be prescribed with caution in selected patients, with careful monitoring of renal function and the potential development of additional squamous cell carcinomas.