Background Kidney transplant is a treatment of choice for end-stage kidney disease, with longer survival and better quality of life post-transplant. However, long-term immunosuppression comes with an increased risk of cancer and infection. Cancer is one of the leading causes of death after kidney transplant. While novel cancer therapies become available, transplant recipients are usually excluded from clinical trials Summary In this review, we summarize the updated knowledge on immunosuppression management in kidney transplant recipients treated with immune checkpoint inhibitors, bispecific T cell engager (BiTE) therapy, and chimeric antigen receptor (CAR) T cell therapies. Key Messages Transplant nephrologists should be empowered to participate in the decision making of cancer treatment together with patients, care partners and oncologist, by managing immunosuppression.