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How are you treating MSI-H CRC in a liver transplant recipient on tacrolimus & sirolimus?

History of OLT (3 years ago), no response to pembro mono tx after 2 mo. Too immunosuppressed?
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How would you treat MSI-H CRC in a liver transplant recipient on immunosuppression?

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2 Answers
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Medical Oncology · Mayo Clinic
Answered on

This is an important question; however, our experience in the metastatic colorectal cancer (mCRC) setting remains very limited. This patient underwent liver transplantation three years ago and has since developed dMMR/MSI-H metastatic colorectal cancer. The patient is currently receiving tacrolimus ...

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Medical Oncology · Mary Lanning Healthcare Morrison Cancer Center/University of Nebraska Medical Center Adjunct Faculty
Answered on

For patients with dMMR/MSI-H metastatic colorectal cancer who have progressed on checkpoint inhibitor (ICI) monotherapy, combination PD-1/CTLA-4 blockade with nivolumab plus ipilimumab is recommended. However, immune checkpoint inhibitors carry a high risk of allograft rejection in solid organ trans...

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