p53 mutations in squamous cell carcinomas from renal transplant recipients

1997 ◽  
Vol 25 (1) ◽  
pp. 342-345 ◽  
Author(s):  
M. A. Bennett ◽  
A. O'Grady ◽  
E. W. Kay ◽  
M. Leader ◽  
G. M. Murphy
Keyword(s):  
Renal Transplant ◽  
Squamous Cell ◽  
Squamous Cell Carcinomas ◽  
Renal Transplant Recipients ◽  
Transplant Recipients ◽  
P53 Mutations

Prevention of skin cancer and reduction of keratotic skin lesions during acitretin therapy in renal transplant recipients: a double-blind, placebo-controlled study.

1995 ◽  
Vol 13 (8) ◽  
pp. 1933-1938 ◽  
Author(s):  
J N Bavinck ◽  
L M Tieben ◽  
F J Van der Woude ◽  
A M Tegzess ◽  
J Hermans ◽  
...  
Keyword(s):  
Placebo Group ◽  
Renal Transplant ◽  
Squamous Cell ◽  
Skin Lesions ◽  
Squamous Cell Carcinomas ◽  
Renal Transplant Recipients ◽  
Transplant Recipients ◽  
Double Blind ◽  
Double Blind Placebo ◽  
Basal Cell Carcinomas

PURPOSE The purpose of this study was to investigate the effect of acitretin on the development of keratotic skin lesions, and on squamous cell carcinomas and basal cell carcinomas in a group of renal transplant recipients. PATIENTS AND METHODS Forty-four renal transplant recipients with more than 10 keratotic skin lesions on the hands and forearms were enrolled onto a randomized, double-blind, placebo-controlled trial to test the possible skin cancer-preventing effect of a 6-month treatment with acitretin 30 mg/d. RESULTS No deterioration in renal function occurred in any of the 38 assessable patients treated. During the 6-month treatment period, two of 19 patients (11%) in the acitretin group reported a total of two new squamous cell carcinomas, compared with nine of 19 patients (47%) in the placebo group who developed a total of 18 new carcinomas (chi 2 = 6.27, P = .01). The relative decrease in the number of keratotic skin lesions in the acitretin group was 13.4%, as compared with a relative increase in the placebo group of 28.2% (difference, 41.6%; 95% confidence interval, 11.5 to 71.7). Most patients treated with acitretin had mild mucocutaneous side effects, but these were easily manageable. Some patients experienced mild hair loss. With the exception of three patients, no increase in serum cholesterol or triglyceride above pretreatment levels was observed, and liver function remained unchanged in all patients. CONCLUSION Acitretin 30 mg/d over 6 months had significantly more effect than placebo in the prevention of squamous cell carcinomas and reduced the occurrence of keratotic skin lesions in a group of renal transplant recipients with severe lesions. This effect was most pronounced in patients with a history of squamous cell carcinomas and basal cell carcinomas.

Two-Year Randomized Controlled Prospective Trial Converting Treatment of Stable Renal Transplant Recipients With Cutaneous Invasive Squamous Cell Carcinomas to Sirolimus

2013 ◽  
Vol 31 (10) ◽  
pp. 1317-1323 ◽  
Author(s):  
Judith M. Hoogendijk-van den Akker ◽  
Paul N. Harden ◽  
Andries J. Hoitsma ◽  
Charlotte M. Proby ◽  
Ron Wolterbeek ◽  
...  
Keyword(s):  
Renal Transplant ◽  
Risk Reduction ◽  
Squamous Cell ◽  
Prospective Trial ◽  
Multivariable Analysis ◽  
Squamous Cell Carcinomas ◽  
Renal Transplant Recipients ◽  
Transplant Recipients ◽  
Randomized Controlled

Purpose In light of the significant morbidity and mortality of cutaneous invasive squamous cell carcinomas (SCCs) in renal transplant recipients, we investigated whether conversion to sirolimus-based immunosuppression from standard immunosuppression could diminish the recurrence rate of these skin cancers. Patients and Methods In a 2-year randomized controlled trial, 155 renal transplant recipients with at least one biopsy-confirmed SCC were stratified according to age (< 55 v ≥ 55 years) and number of previous SCCs (one to nine v ≥ 10) and randomly assigned to conversion to sirolimus (n = 74) or continuation of their original immunosuppression (n = 81). Development of a new SCC within 2 years after random assignment was the primary end point. Results After 2 years of follow-up, the risk reduction of new SCCs in the multivariable analysis was not significant, with a hazard ratio (HR) of 0.76 (95% CI, 0.48 to 1.2; P = .255), compared with a non–sirolimus-based regimen. After the first year, there was a significant 50% risk reduction, with an HR of 0.50 (95% CI, 0.28 to 0.90; P = .021) for all patients together and an HR of 0.11 (95% CI, 0.01 to 0.94; P = .044) for patients with only one previous SCC. The tumor burden of SCC was reduced during the 2-year follow-up period in those receiving sirolimus (0.82 v 1.38 per year; HR, 0.51; 95% CI, 0.32 to 0.82; P = .006) if adjusted for the number of previous SCCs and age. Twenty-nine patients stopped taking sirolimus because of various adverse events. Conclusion Conversion to sirolimus-based immunosuppression failed to show a benefit in terms of SCC-free survival at 2 years.

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