LUNG transplantation can be safely performed in men with newly diagnosed, localized high-risk prostate cancer prior to definitive cancer treatment, according to a new case review. In carefully selected patients, delaying prostate cancer therapy to prioritize urgent transplant may be a viable approach in experienced transplant centers.
A single-center retrospective review examined two men diagnosed with high-risk prostate adenocarcinoma during pretransplant malignancy screening who underwent lung transplantation before receiving definitive cancer treatment. One patient had interstitial lung disease and the other had post-COVID pulmonary fibrosis. Both had World Health Organization (WHO) group III pulmonary hypertension and required expedited transplantation.
The first patient received androgen deprivation therapy before transplant, followed by external beam radiotherapy after the procedure. The second patient has yet to receive definitive oncologic therapy. At 24 and 10 months post-transplant respectively, both patients remain alive with ongoing management of their localized prostate cancer.
Prostate adenocarcinoma’s relatively non-immunogenic profile, coupled with the availability of effective non-chemotherapeutic treatments such as androgen deprivation, may allow for temporary deferral of oncologic treatment without significantly increasing risk. These cases highlight the importance of individualized decision-making and multidisciplinary coordination in transplant oncology.
The findings support a shift in perspective around organ allocation in the setting of concurrent cancer diagnosis. With the right safeguards and expertise, patients with localized high-risk prostate cancer may still benefit from timely, life-saving transplantation without compromising long-term oncologic outcomes.
Reference:
Slota JM et al. Lung Transplantation in Men With High-Risk Prostate Cancer. Case Reports Clin Transplant. 2025;39(8):e70269.
