WCLC 2025 - Posters & ePosters-P2.08 .01 Double Lung Transplantation in Patients With Recent History of Malignancy

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This study evaluates the outcomes of double lung transplantation (DLT) in patients with a recent history of malignancy (within five years), a group traditionally considered at higher risk and often contraindicated for transplantation. Conducted at Northwestern University, the prospective DREAM registry study cohort C (NCT05671887) identified 19 patients undergoing DLT between September 2021 and July 2025. Patients had respiratory failure accompanied by prior cancers including lung, prostate, testis, bladder, breast, and skin cancers. Prior cancer treatments varied, including chemoradiotherapy, immunotherapy, radiotherapy, and chemotherapy.<br /><br />Key patient characteristics showed a median age of 56 years (range 27-74), with a majority being former smokers (68%) and predominantly white (73%). All patients received rigorous cancer staging confirming no metastasis before transplantation. Indications for DLT were mostly interstitial lung disease (63%), COPD (26%), or mixed conditions.<br /><br />Outcomes were promising: no perioperative mortality directly linked to cancer history, with all discharged without supplemental oxygen. Median follow-up was 17 months (range 1-54 months). Complications included one hyperacute rejection, one patient death due to presumed cardiac cause, one new pancreatic cancer, and one recurrence of prior lung cancer at four months post-transplant. Importantly, cancer recurrence and new malignancies were isolated events without excess early mortality.<br /><br />This data suggests that carefully selected patients with recent malignancy history can safely undergo DLT with acceptable outcomes. The study highlights the feasibility and perioperative safety of DLT in this population, challenging the traditional contraindication based solely on cancer history. Ongoing prospective monitoring through DREAM aims to further define long-term safety in this high-risk group.<br /><br />In conclusion, recent malignancy should be considered a relative, not absolute, contraindication to double lung transplantation, expanding potential treatment options for these complex patients.

Asset Subtitle

Young Chae

Meta Tag

Speaker Young Chae

Topic Local-Regional Non-small Cell Lung Cancer

Keywords

double lung transplantation

recent malignancy

DREAM registry

Northwestern University

interstitial lung disease

COPD

cancer recurrence

perioperative safety

lung transplant outcomes

immunotherapy