Abstract CT211: Double lung transplantation in patients with recent history of malignancy

Abstract Background: Having a recent history of cancer has often been considered a contraindication for double lung transplantation (DLT) due to concerns about the potential for cancer recurrence and poor outcomes. However, the relationship between recent cancer history and mortality following lung transplantation is still unclear. Methods: This study encompassed ll patients who received DLT at a single institution between September 2021 and January 2025 and presented with a recent history of other cancers. All patients were enrolled in cohort C of the DLT registry aimed for lung-limited malignancies (DREAM) study (NCT05671887). Exclusion criteria included the presence of extrapulmonary metastatic disease and medical ineligibility for DLT. Patients were monitored using computed tomography scans every 12 weeks. Results: A total of thirteen patients were included in this study. Ten patients (77%) were diagnosed with non-small cell lung carcinoma (NSCLC) at stages Ib-IIIb, two patients (15%) had prostate adenocarcinoma (at stages IIc and IIIb), and one patient (8%) had bladder cancer (Stage I). The median duration of no evidence of disease was 14 months, with a range of 0 to 53 months. The patients' ages ranged from 57 to 75 years, with eight patients (61%) being male. The indications for DLT included chronic obstructive pulmonary disease (4 out of 13, or 31%), interstitial lung disease (ILD) (5 out of 13, or 38%), and idiopathic pulmonary fibrosis (4 out of 13, or 31%). All patients had high oxygen requirements before undergoing DLT. The median duration of wait time on the transplant list was 36 days, with a range of 2 to 86 days. There were no instances of in-hospital mortality, and the median duration of hospital stay was 16 days, with a range from 8 days to the time of discharge. No cases of rejection or post-transplant malignancy were reported during a median follow-up period of 11 months, with a range of 6 to 21 months. One patient, who had scleroderma-related ILD, died 6 months post-transplant due to cardiac arrest. Conclusions: Thirteen patients with a history of malignancy successfully underwent DLT without significant complications. The median follow-up period post-transplantation was 11 months (6 to 21 months). The ongoing DREAM study, specifically cohort C, will continue to explore the implications of DLT in patients with a recent history of malignancy. Citation Format: Tarik Demir, Young Kwang Chae, Chitaru Kurihara, Liam Il-Young Chung, Wongi Woo, Carolyn Moloney, Brooke Sanson, Rose Dwyer, Chan Mi Jung, Rade Tomic, Ankit Bharat. Double lung transplantation in patients with recent history of malignancy [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2025; Part 2 (Late-Breaking, Clinical Trial, and Invited Abstracts); 2025 Apr 25-30; Chicago, IL. Philadelphia (PA): AACR; Cancer Res 2025;85(8_Suppl_2):Abstract nr CT211.