Best of JAMA 2025: Episode 5:Outcomes of Solid Organ Transplant Recipients With Advanced Cancers Receiving Immune Checkpoint Inhibitors A Systematic Review and Individual Participant Data Meta-Analysis

This comprehensive meta-analysis investigates the delicate balance between treating aggressive cancers and preserving donor organs in solid organ transplant recipients. Researchers discovered that while immune checkpoint inhibitors offer a vital lifeline, they carry a substantial risk of acute rejection and graft loss because the stimulated immune system may attack the transplanted organ. The study highlights that clinical success varies significantly by disease, with cutaneous squamous cell carcinomashowing much better response rates than melanoma or other solid tumors. Ultimately, the findings suggest a potential breakthrough in safety, noting that combining steroids with mTOR inhibitors may shield the graft from rejection without compromising the cancer treatment's effectiveness.