Unmet Needs in Transplant Recipients and Immunocompromised Patients

Dr In and Dr Dunn turn to remaining unmet needs in advanced cutaneous squamous cell carcinoma, focusing on high-risk populations routinely excluded from pivotal trials, including solid organ transplant recipients, patients with hematologic malignancies, and those with autoimmune disease. Dr Dunn raises allograft rejection as a central question, noting that rejection rates with anti–PD-1 inhibition have been reported at 36% to 46%, and asks whether the relatively more favorable toxicity profile observed with cosibelimab might translate into a lower rejection rate, which would make the agent appealing for transplant recipients who develop locally advanced disease not amenable to curative treatment or who develop metastatic disease. Dr In agrees this population is especially challenging, noting that transplant recipients face a several hundredfold higher risk of aggressive squamous cell carcinoma because of their immunosuppressive regimens, and confirms that studies examining cosibelimab in this setting are ongoing.