Nav: Home

Northwell Health's Feinstein Institute discovers cancer treatment for transplant patients

January 18, 2017

Kenar D. Jhaveri, MD, and Richard Barnett, MD, Feinstein Institute for Medical Research scientists and Northwell Health Department of Internal Medicine nephrologists, published a Letter to the Editor in the prestigious New England Journal of Medicine, which profiles a novel drug combination with the potential to help prevent rejection of a donor kidney in transplant patients undergoing cancer treatment. The novel drug combination allows the rapidly emerging cancer therapies called immune checkpoint inhibitors to be incorporated into a transplant patient's cancer treatment regimen. This observation shows promise for people undergoing cancer therapy who have also had a kidney transplant.

The goal of any course of cancer treatment is to prevent and/or kill future growth of malignant cells. Sometimes this can be challenging as some cancer cells "trick" the immune system into thinking they are healthy cells. Doctors are seeing promise in a group of drugs called immune checkpoint inhibitors, which activate the immune system to attack the cancer. While effective in most cancer patients, this course of treatment has been less successful in kidney transplant patients because if the immune system is activated, it causes the patient's body to start rejecting their donor kidney. Dr. Jhaveri and Dr. Barnett observed during the treatment of a patient living with cancer who had a kidney transplant that the combination of steroids and sirolimus, an immunosuppressant that has anti-cancer properties, could prevent a patient's body from rejecting the organ during cancer treatment with immune checkpoint inhibitors.

In the case that Drs. Jhaveri and Barnett outline in their Letter to the Editor, they observed the treatment of a 70 year-old Caucasian male who received a kidney transplant in 2010 and recently underwent treatment for small bowel cancer which had spread to the liver. The patient was given prednisone, a steroid, and an immunosuppressant (sirolimus) prior to incorporating an immune checkpoint inhibitor (nivolumab). The patient's kidney did not experience any rejection and the cancer regressed as well. In addition, the patient was able to receive the full benefit of this immunotherapy, which attacked the cancer cells without having an effect on the transplant organ. Eight months later, the patient is enjoying his day-to-day life and able to fight his cancer without any rejection of his transplanted kidney.

"In reviewing this patient's case, I think we might have found a novel strategy of using pre-emptive steroids and sirolimus to mitigate organ rejection in transplant patients receiving cancer treatment involving PD-1 inhibitors," said Dr. Jhaveri, associate chief of the Division of Kidney Diseases and Hypertension in Northwell Health's Department of Internal Medicine. "This letter highlights the use of a novel regimen and may give the patients with a kidney transplant and cancer hope of treating the cancer while keeping the kidney and thereby avoiding dialysis."

Thomas McGinn, MD, MPH, center head for the Feinstein Institute's Merinoff Center for Patient-Oriented Research and chair of Northwell Health's Department of Internal Medicine, said: "This work will be important as the use of these cancer agents increases. I commend the authors on a bold and innovative approach in management of a very tough clinical situation."

"Important discoveries begin with a novel observation," said Kevin J. Tracey, MD, president and CEO of the Feinstein Institute. "I hope that the medical science community now will build on Dr. Jhaveri's discovery so that patients with cancer who must also undergo a kidney transplant can benefit."
-end-


Northwell Health

Related Cancer Articles:

Cancer mortality continues steady decline, driven by progress against lung cancer
The cancer death rate declined by 29% from 1991 to 2017, including a 2.2% drop from 2016 to 2017, the largest single-year drop in cancer mortality ever reported.
Stress in cervical cancer patients associated with higher risk of cancer-specific mortality
Psychological stress was associated with a higher risk of cancer-specific mortality in women diagnosed with cervical cancer.
Cancer-sniffing dogs 97% accurate in identifying lung cancer, according to study in JAOA
The next step will be to further fractionate the samples based on chemical and physical properties, presenting them back to the dogs until the specific biomarkers for each cancer are identified.
Moffitt Cancer Center researchers identify one way T cell function may fail in cancer
Moffitt Cancer Center researchers have discovered a mechanism by which one type of immune cell, CD8+ T cells, can become dysfunctional, impeding its ability to seek and kill cancer cells.
More cancer survivors, fewer cancer specialists point to challenge in meeting care needs
An aging population, a growing number of cancer survivors, and a projected shortage of cancer care providers will result in a challenge in delivering the care for cancer survivors in the United States if systemic changes are not made.
New cancer vaccine platform a potential tool for efficacious targeted cancer therapy
Researchers at the University of Helsinki have discovered a solution in the form of a cancer vaccine platform for improving the efficacy of oncolytic viruses used in cancer treatment.
American Cancer Society outlines blueprint for cancer control in the 21st century
The American Cancer Society is outlining its vision for cancer control in the decades ahead in a series of articles that forms the basis of a national cancer control plan.
Oncotarget: Cancer pioneer employs physics to approach cancer in last research article
In the cover article of Tuesday's issue of Oncotarget, James Frost, MD, PhD, Kenneth Pienta, MD, and the late Donald Coffey, Ph.D., use a theory of physical and biophysical symmetry to derive a new conceptualization of cancer.
Health indicators for newborns of breast cancer survivors may vary by cancer type
In a study published in the International Journal of Cancer, researchers from the UNC Lineberger Comprehensive Cancer Center analyzed health indicators for children born to young breast cancer survivors in North Carolina.
Few women with history of breast cancer and ovarian cancer take a recommended genetic test
More than 80 percent of women living with a history of breast or ovarian cancer at high-risk of having a gene mutation have never taken the test that can detect it.
More Cancer News and Cancer Current Events

Trending Science News

Current Coronavirus (COVID-19) News

Top Science Podcasts

We have hand picked the top science podcasts of 2020.
Now Playing: TED Radio Hour

Climate Mindset
In the past few months, human beings have come together to fight a global threat. This hour, TED speakers explore how our response can be the catalyst to fight another global crisis: climate change. Guests include political strategist Tom Rivett-Carnac, diplomat Christiana Figueres, climate justice activist Xiye Bastida, and writer, illustrator, and artist Oliver Jeffers.
Now Playing: Science for the People

#562 Superbug to Bedside
By now we're all good and scared about antibiotic resistance, one of the many things coming to get us all. But there's good news, sort of. News antibiotics are coming out! How do they get tested? What does that kind of a trial look like and how does it happen? Host Bethany Brookeshire talks with Matt McCarthy, author of "Superbugs: The Race to Stop an Epidemic", about the ins and outs of testing a new antibiotic in the hospital.
Now Playing: Radiolab

Speedy Beet
There are few musical moments more well-worn than the first four notes of Beethoven's Fifth Symphony. But in this short, we find out that Beethoven might have made a last-ditch effort to keep his music from ever feeling familiar, to keep pushing his listeners to a kind of psychological limit. Big thanks to our Brooklyn Philharmonic musicians: Deborah Buck and Suzy Perelman on violin, Arash Amini on cello, and Ah Ling Neu on viola. And check out The First Four Notes, Matthew Guerrieri's book on Beethoven's Fifth. Support Radiolab today at Radiolab.org/donate.