Outcome of pretransplant melanoma after solid organ transplantation: an observational study

The number of patients with a history of melanoma who are awaiting a solid organ transplantation (SOT) is increasing. Few recommendations exist on the timing to transplantation after melanoma diagnosis. The aim of this study was to assess the melanoma recurrence‐free survival after pretransplant melanoma (PTM). We conducted a multicenter ambispective observational study. Organ transplant recipients (OTR) with a history of PTM and complete AJCC staging were included. Thirty‐seven patients (predominantly men with a renal allograft) were included. Five melanomas were in situ, 21 stage IA, 4 stage IB, 5 stage II, and 2 stage IIIB. The median post‐transplantation follow‐up time was 4 years. Sixty‐two percent of patients were followed up more than 2 years. Recurrence‐free survival since melanoma reached 89.9%, but varied significantly according to AJCC staging (P = 0.0129). Three patients presented a recurrence. Despite the rather limited sample size and a wide range of follow‐up, our findings concerning the recurrence‐free survival appear reassuring for in situ and stage IA PTM; accordingly, we suggest that a waiting time to transplantation is not mandatory in patients with in situ or stage IA PTM, especially whenever SOT is urgently needed. Caution is, however, needed for patients with higher stage.

[1]  A. Webster,et al.  Organ transplantation and outcomes in patients with a past history of melanoma: A systematic review and meta‐analysis , 2021, Clinical transplantation.

[2]  D. Al-Adra,et al.  Analysis of malignant melanoma risk and outcomes in solid organ transplant recipients: Assessment of transplant candidacy and the potential role of checkpoint inhibitors , 2021, Clinical transplantation.

[3]  P. Bierman,et al.  Preexisting melanoma and hematological malignancies, prognosis, and timing to solid organ transplantation: A consensus expert opinion statement , 2020, American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons.

[4]  P. Austin,et al.  Melanoma incidence, stage, and survival after solid organ transplant: A population-based cohort study in Ontario, Canada. , 2020, Journal of the American Academy of Dermatology.

[5]  Solid Organ , 2020, Definitions.

[6]  N. Zeitouni,et al.  Immune checkpoint inhibitor therapy in solid organ transplant recipients: A patient-centered systematic review. , 2020, Journal of the American Academy of Dermatology.

[7]  Peng Zhang,et al.  EMP2 acts as a suppressor of melanoma and is negatively regulated by mTOR-mediated autophagy , 2019, Journal of Cancer.

[8]  G. Opelz,et al.  Pretransplant Cancer in Kidney Recipients in Relation to Recurrent and De Novo Cancer Incidence Posttransplantation and Implications for Graft and Patient Survival , 2019, Transplantation.

[9]  P. Ascierto,et al.  Anti-PD-1/PD-L1 immunotherapy in patients with solid organ transplant, HIV or hepatitis B/C infection. , 2018, European journal of cancer.

[10]  P. Mosca,et al.  Outcomes of patients with a pretransplant history of early-stage melanoma , 2018, Melanoma research.

[11]  S. Kim,et al.  Solid Organ Transplantation in Patients With Preexisting Malignancies in Remission: A Propensity Score Matched Cohort Study , 2018, Transplantation.

[12]  A. Gavin,et al.  Trends in incidence of thick, thin and in situ melanoma in Europe. , 2018, European journal of cancer.

[13]  E. Decullier,et al.  Increasing incidence of melanoma after solid organ transplantation: a retrospective epidemiological study , 2017, Transplant international : official journal of the European Society for Organ Transplantation.

[14]  Jeffrey E Gershenwald,et al.  Melanoma staging: Evidence‐based changes in the American Joint Committee on Cancer eighth edition cancer staging manual , 2017, CA: a cancer journal for clinicians.

[15]  C. Holt Overview of Immunosuppressive Therapy in Solid Organ Transplantation. , 2017, Anesthesiology clinics.

[16]  E. Huang,et al.  Association of Pretransplant Skin Cancer With Posttransplant Malignancy, Graft Failure and Death in Kidney Transplant Recipients , 2017, Transplantation.

[17]  G. Enblad,et al.  High Posttransplant Cancer Incidence in Renal Transplanted Patients With Pretransplant Cancer , 2017, Transplantation.

[18]  J. Bouwes Bavinck,et al.  Risk of Aggressive Skin Cancers After Kidney Retransplantation in Patients With Previous Posttransplant Cutaneous Squamous Cell Carcinomas: A Retrospective Study of 53 Cases , 2017, Transplantation.

[19]  K. Jhaveri,et al.  Preserved Renal-Allograft Function and the PD-1 Pathway Inhibitor Nivolumab. , 2017, The New England journal of medicine.

[20]  J. Cooper,et al.  Acute antibody-mediated rejection in kidney transplant recipients. , 2017, Transplantation reviews.

[21]  U. Maggiore,et al.  The Bad and the Good News on Cancer Immunotherapy: Implications for Organ Transplant Recipients. , 2016, Advances in chronic kidney disease.

[22]  C. McCulloch,et al.  Melanoma Outcomes in Transplant Recipients With Pretransplant Melanoma , 2016, Dermatologic surgery : official publication for American Society for Dermatologic Surgery [et al.].

[23]  S. Arron,et al.  Recommendations for Solid Organ Transplantation for Transplant Candidates With a Pretransplant Diagnosis of Cutaneous Squamous Cell Carcinoma, Merkel Cell Carcinoma and Melanoma: A Consensus Opinion From the International Transplant Skin Cancer Collaborative (ITSCC) , 2016, American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons.

[24]  S. Arron,et al.  Melanoma risk and survival among organ transplant recipients , 2015, The Journal of investigative dermatology.

[25]  B. Rozell,et al.  Cutaneous malignant melanoma in the Swedish organ transplantation cohort: A study of clinicopathological characteristics and mortality. , 2015, Journal of the American Academy of Dermatology.

[26]  Greta M. Massetti,et al.  Vital Signs: Melanoma Incidence and Mortality Trends and Projections — United States, 1982–2030 , 2015, MMWR. Morbidity and mortality weekly report.

[27]  A. Webster,et al.  Survival After Cutaneous Melanoma in Kidney Transplant Recipients: A Population‐Based Matched Cohort Study , 2014, American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons.

[28]  A. Chan,et al.  Systematic review of melanoma incidence and prognosis in solid organ transplant recipients , 2014, Transplantation research.

[29]  R. Snanoudj,et al.  T-cell-depleting antibodies and risk of cancer after transplantation. , 2014, Transplantation.

[30]  F. Granath,et al.  Overall and Cause-Specific Mortality in Transplant Recipients with a Pretransplantation Cancer History , 2013, Transplantation.

[31]  Hongyu Zhou,et al.  Chinese Anti鄄 Cancer a Ssociation , 2022 .

[32]  A. Weaver,et al.  Malignant melanoma in solid transplant recipients: collection of database cases and comparison with surveillance, epidemiology, and end results data for outcome analysis. , 2011, Archives of dermatology.

[33]  D Ratner,et al.  Melanoma in Solid Organ Transplant Recipients , 2010, American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons.

[34]  J. Bouwes Bavinck,et al.  Melanoma in Organ Transplant Recipients: Clinicopathological Features and Outcome in 100 Cases , 2008, American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons.

[35]  A. Weaver,et al.  Outcomes of melanoma in recipients of solid organ transplant. , 2008, Journal of the American Academy of Dermatology.

[36]  J. Doroshow,et al.  CCI‐779 in metastatic melanoma , 2005, Journal of clinical oncology : official journal of the American Society of Clinical Oncology.

[37]  J. Doroshow,et al.  CCI-779 in metastatic melanoma: a phase II trial of the California Cancer Consortium. , 2004, Cancer.

[38]  J. Chapman,et al.  Recurrence of cancer after renal transplantation. , 2001, Transplantation proceedings.

[39]  I. Penn Malignant melanoma in organ allograft recipients. , 1996, Transplantation.

[40]  P. A. Bowen,et al.  The evaluation of renal transplant candidates: clinical practice guidelines. Patient Care and Education Committee of the American Society of Transplant Physicians. , 1995, Journal of the American Society of Nephrology : JASN.