scholarly journals Increased Risk of Squamous-Cell Carcinoma in Simultaneous Pancreas Kidney Transplant Recipients Compared with Kidney Transplant Recipients

2009 ◽  
Vol 129 (12) ◽  
pp. 2886-2894 ◽  
Author(s):  
Hermina C. Wisgerhof ◽  
Paul J.M. van der Boog ◽  
Johan W. de Fijter ◽  
Ron Wolterbeek ◽  
Geert W. Haasnoot ◽  
...  
Keyword(s):  
Squamous Cell Carcinoma ◽  
Cell Carcinoma ◽  
Kidney Transplant ◽  
Squamous Cell ◽  
Transplant Recipients ◽  
Kidney Transplant Recipients ◽  
Increased Risk ◽  
Simultaneous Pancreas Kidney

Sirolimus for Secondary Prevention of Skin Cancer in Kidney Transplant Recipients: 5-Year Results

2018 ◽  
Vol 36 (25) ◽  
pp. 2612-2620 ◽  
Author(s):  
Jacques Dantal ◽  
Emmanuel Morelon ◽  
Lionel Rostaing ◽  
Eric Goffin ◽  
Anabelle Brocard ◽  
...  
Keyword(s):  
Squamous Cell Carcinoma ◽  
Cell Carcinoma ◽  
Kidney Transplant ◽  
Squamous Cell ◽  
Calcineurin Inhibitor ◽  
Calcineurin Inhibitors ◽  
Squamous Cell Carcinomas ◽  
Transplant Recipients ◽  
Kidney Transplant Recipients ◽  
Skin Cancers

Purpose Transplant recipients who develop cutaneous squamous cell carcinomas are at high risk for multiple subsequent skin cancers. Sirolimus has been shown to reduce the occurrence of secondary skin cancers, but no study included a follow-up exceeding 2 years. We extended at 5 years the TUMORAPA randomized trial of sirolimus-based immunosuppressive regimen versus calcineurin inhibitor–based immunosuppression. Methods Kidney transplant recipients receiving calcineurin inhibitors who had at least one cutaneous squamous cell carcinoma were randomly assigned to receive sirolimus as a substitute for calcineurin inhibitors (n = 64) or to maintain their initial treatment (n = 56). The primary end point was survival free of squamous cell carcinoma at 5 years. Secondary end points included the occurrence of other skin cancers, renal function, patient and graft survival, and treatment tolerance. Results Survival free of cutaneous squamous cell carcinoma was significantly longer in the sirolimus group than in the calcineurin inhibitor group ( P = .007). In the sirolimus group, the number of patients with new skin cancers was significantly lower compared with the calcineurin inhibitor group: 22% versus 59% for squamous cell carcinomas ( P < .001), 34% versus 66% for other skin cancers ( P < .001), and 20% versus 37.5% for basal cell carcinomas ( P < .05). Kidney graft function, patients, and graft survival were similar in both groups. In the sirolimus group, the mean number of serious adverse effects per patient decreased from 1.16 during the first 2 years, to 0.83 between years 2 and 5. Conclusion In kidney transplant recipients with previous cutaneous squamous cell carcinomas, the antitumoral effect of conversion from calcineurin inhibitors to sirolimus was maintained at 5 years, and sirolimus tolerance was satisfactory.

De-Methylation of the TSDR Is a Marker of Squamous Cell Carcinoma in Kidney Transplant Recipients.

2014 ◽  
Vol 98 ◽  
pp. 321
Author(s):  
S. Sherston ◽  
K. Vogt ◽  
S. Schlickeiser ◽  
B. Sawitzki ◽  
P. Harden ◽  
...  
Keyword(s):  
Squamous Cell Carcinoma ◽  
Cell Carcinoma ◽  
Kidney Transplant ◽  
Squamous Cell ◽  
Transplant Recipients ◽  
Kidney Transplant Recipients

scholarly journals Association between Use of Hydrochlorothiazide and Risk of Keratinocyte Cancers in Kidney Transplant Recipients

2020 ◽  
Vol 15 (12) ◽  
pp. 1804-1813
Author(s):  
Thibault Letellier ◽  
Florent Leborgne ◽  
Clarisse Kerleau ◽  
Aurélie Gaultier ◽  
Jacques Dantal ◽  
...  
Keyword(s):  
Cell Carcinoma ◽  
Kidney Transplant ◽  
Squamous Cell ◽  
Basal Cell ◽  
Squamous Cell Carcinomas ◽  
Transplant Recipients ◽  
Single Center ◽  
Kidney Transplant Recipients ◽  
Basal Cell Carcinomas ◽  
Keratinocyte Cancer

Background and objectivesKeratinocyte cancers, which primarily comprise squamous cell carcinomas and basal cell carcinomas, represent a major concern and potential risk for kidney transplant recipients. Hydrochlorothiazide, a diuretic widely used to treat hypertension, has been implicated in skin photosensitivity reaction. Recent studies conducted in the general population have found that hydrochlorothiazide use is associated with a higher risk of keratinocyte cancer, especially squamous cell carcinomas. High-risk groups, however, including transplant recipients were excluded from these. Our aim was to investigate whether hydrochlorothiazide use was associated with keratinocyte cancer in kidney transplant recipients on immunosuppressive therapy.Design, setting, participants, & measurementsIn a single-center cohort of kidney (n=2155), combined kidney-pancreas (n=282), and pancreas (n=59) transplant recipients from the Données Informatisées VAlidées Transplantation (DIVAT) database transplanted between 2000 and 2017 in Nantes, France, we evaluated the association between hydrochlorothiazide exposure and keratinocyte cancers. Multivariable cause-specific, time-varying Cox models were used to estimate the relationship between hydrochlorothiazide exposure and the hazard of squamous cell carcinoma and basal cell carcinoma, with hydrochlorothiazide designated as the time-dependent variable.ResultsAmong the participants, 279 of 2496 (11%) were exposed to hydrochlorothiazide after the transplantation. Cumulative incidence rates of keratinocyte cancer by 10 and 15 years were 7% and 9% for squamous cell carcinomas, respectively, and 8% and 11% for basal cell carcinomas, respectively. We found a relationship between exposure to hydrochlorothiazide and the risk of squamous cell carcinomas (hazard ratio, 2.04; 95% confidence interval, 1.27 to 3.28). In contrast, we found no association between hydrochlorothiazide exposure and basal cell carcinomas (hazard ratio, 0.63; 95% confidence interval, 0.35 to 1.15).ConclusionsIn a single-center cohort of kidney, combined kidney-pancreas, and pancreas transplant recipients, exposure to hydrochlorothiazide was associated with a two-fold higher risk of squamous cell carcinoma and no higher risk of basal cell carcinoma.

Renal cell carcinoma in kidney transplant recipients at Guy’s and King’s College Hospital (UK) between 1987-2018.

2019 ◽  
Vol 37 (15_suppl) ◽  
pp. e16066-e16066
Author(s):  
Sabeeh-Ur-Rehman Butt ◽  
Barbara Chow ◽  
Sapna Shah ◽  
Iain MacDougall ◽  
Catriona Shaw ◽  
...  
Keyword(s):  
Renal Cell Carcinoma ◽  
Kidney Disease ◽  
Cell Carcinoma ◽  
Kidney Transplant ◽  
Renal Cell ◽  
High Risk Population ◽  
Solid Cancer ◽  
Transplant Recipients ◽  
Kidney Transplant Recipients ◽  
Increased Risk

e16066 Background: The increased incidence of cancer after renal transplantation is well recognised. Differences in cancer risk depend on the type of cancer but overall the incidence of solid cancer in kidney transplant recipient is at least twofold. Long term immunosuppression, oncogenic viruses and changes in immune surveillance are contributing factors. The incidence of renal cell carcinoma (RCC) is approximately six-fold greater than in the general population. Screening for RCC in the post-transplantation setting is not routine. Methods: Retrospective case series of kidney transplant recipients who underwent transplantation between 1987 and 2018 at Guy’s Hospital (London, UK). Collected data on patients who developed RCC post-transplant included: baseline demographics, renal disease, transplant survival, tumour characteristics, cancer treatment and survival. Results: 2968 patients underwent kidney transplantation between 1987 and 2018 at our Centre. 52 patients (1.8%) developed RCC. 40 (74%) were male with a median age of 51 years. 37% (71%) were white and 12 (23%) were black. The causes of end stage kidney disease included IgA nephropathy, hypertension and polycystic kidney disease. Median time to RCC diagnosis after transplant was 9 years (range 0-27). 86% of patients presented with stage 1/2 tumours, with the majority (72%) occurring in native kidneys. Most underwent radical nephrectomy although 5 patients were managed with radiofrequency-ablation (RFA) or surveillance (donor kidneys). Of 6 patients with metastatic disease, 5 received pazopanib and 1 everolimus. 4 patients continued systemic therapy for over 3 months and all derived clinical benefit with a median drug exposure of 19 months .15 patients required further kidney transplant or dialysis. Overall only 2 patients died from RCC. Conclusions: This retrospective study is the largest single-centre UK study to our knowledge. Kidney transplant recipients experience a marked increased risk of developing RCC. Most diagnosed RCCs are small and disease-specific mortality is low. With a third of tumours arising in donor organs, questions around optimum loco-regional approach and screening of high-risk population remain unanswered.

scholarly journals Safe Administration of Cemiplimab to a Kidney Transplant Patient with Locally Advanced Squamous Cell Carcinoma of the Scalp

2021 ◽  
Vol 28 (1) ◽  
pp. 574-580
Author(s):  
Luca Paoluzzi ◽  
Thomas J Ow
Keyword(s):  
Squamous Cell Carcinoma ◽  
Cell Carcinoma ◽  
Kidney Transplant ◽  
Squamous Cell ◽  
Locally Advanced ◽  
Kidney Transplant Patient ◽  
Cell Transplant ◽  
Renal Transplant Recipients ◽  
Advanced Squamous Cell Carcinoma ◽  
Hematopoietic Stem

Immunotherapies directed at T-cell activation through antibodies targeting checkpoint proteins, such as programmed cell death 1 (PD1), are rapidly becoming the new standard of care in the treatment of several malignancies. Cemiplimab is a monoclonal antibody targeting PD1 that has recently emerged as a highly active treatment for locally advanced and metastatic cutaneous squamous cell carcinoma (CSCC). Patients who have received an organ transplant (OTRs) have been traditionally excluded from clinical trials with checkpoint inhibitors (CIs), given concerns for organ rejection. Renal transplant recipients (RTRs) are more likely to develop cancers than the general population, and skin cancers are among the most frequent malignancies. We report the case of a 72-year-old man with a history of a kidney transplant who presented with a rapidly growing, locally advanced squamous cell carcinoma (SCC) of the scalp that recurred within four weeks from surgical resection. The patient was able to safely receive ten cycles of cemiplimab so far with significant clinical benefit, and no issues with his kidney function, while continuing immunosuppression with low dose prednisone alone. An ongoing clinical trial (NCT04339062) is further exploring the safety of CIs in patients with metastatic CSCC who have previously received allogeneic hematopoietic stem cell transplant or a kidney transplant.

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