scholarly journals Everolimus and Malignancy after Solid Organ Transplantation: A Clinical Update

2016 ◽  
Vol 2016 ◽  
pp. 1-11 ◽  
Author(s):  
Hallvard Holdaas ◽  
Paolo De Simone ◽  
Andreas Zuckermann
Keyword(s):  
Organ Transplantation ◽  
Mtor Inhibitor ◽  
De Novo ◽  
Case Reports ◽  
Meta Analysis ◽  
Mammalian Target Of Rapamycin ◽  
Solid Organ Transplantation ◽  
Population Data ◽  
Solid Organ ◽  
Mtor Inhibition

Malignancy after solid organ transplantation remains a major cause of posttransplant mortality. The mammalian target of rapamycin (mTOR) inhibitor class of immunosuppressants exerts various antioncogenic effects, and the mTOR inhibitor everolimus is licensed for the treatment of several solid cancers. In kidney transplantation, evidence from registry studies indicates a lower rate ofde novomalignancy under mTOR inhibition, with some potentially supportive data from randomized trials of everolimus. Case reports and small single-center series have suggested that switch to everolimus may be beneficial following diagnosis of posttransplant malignancy, particularly for Kaposi’s sarcoma and nonmelanoma skin cancer, but prospective studies are lacking. A systematic review has shown mTOR inhibition to be associated with a significantly lower rate of hepatocellular carcinoma (HCC) recurrence versus standard calcineurin inhibitor therapy. One meta-analysis has concluded that patients with nontransplant HCC experience a low but significant survival benefit under everolimus monotherapy, so far unconfirmed in a transplant population. Data are limited in heart transplantation, although observational data and case reports have indicated that introduction of everolimus is helpful in reducing the recurrence of skin cancers. Overall, it can be concluded that, in certain settings, everolimus appears a promising option to lessen the toll of posttransplant malignancy.

scholarly journals De Novo Carcinoma after Solid Organ Transplantation to Give Insight into Carcinogenesis in General—A Systematic Review and Meta-Analysis

Cancers ◽  
2021 ◽  
Vol 13 (5) ◽  
pp. 1122
Author(s):  
Eline S. Zwart ◽  
Esen Yüksel ◽  
Anne Pannekoek ◽  
Ralph de Vries ◽  
Reina E. Mebius ◽  
...  
Keyword(s):  
Organ Transplantation ◽  
De Novo ◽  
Meta Analysis ◽  
Solid Organ Transplantation ◽  
Head And Neck Carcinoma ◽  
Immunosuppressive Drugs ◽  
Solid Organ ◽  
Neck Carcinoma ◽  
Carcinogenic Process ◽  
Insight Into

Immunosuppressive therapy after solid organ transplantation leads to the development of cancer in many recipients. Analysis of the occurrence of different types of de novo carcinomas in relation to specific immunosuppressive drugs may give insight into their carcinogenic process and carcinogenesis in general. Therefore, a systematic search was performed in Embase and PubMed. Studies describing over five de novo carcinomas in patients using immunosuppressive drugs after solid organ transplantation were included. Incidence per 1000 person-years was calculated with DerSimonian–Laird random effects model and odds ratio for developing carcinomas with the Mantel–Haenszel test. Following review of 5606 papers by title and abstract, a meta-analysis was conducted of 82 studies. The incidence rate of de novo carcinomas was 8.41. Patients receiving cyclosporine developed more de novo carcinomas compared to tacrolimus (OR1.56, 95%CI 1.00–2.44) and mycophenolate (OR1.26, 95%CI 1.03–1.56). Patients receiving azathioprine had higher odds to develop de novo carcinomas compared to mycophenolate (OR3.34, 95%CI 1.29–8.65) and head and neck carcinoma compared to tacrolimus (OR3.78, 95%CI 1.11–12.83). To conclude, patients receiving immunosuppressive drugs after solid organ transplantation have almost a 20-fold increased likelihood of developing carcinomas, with the highest likelihood for patients receiving cyclosporine A and azathioprine. Looking into altered immune pathways affected by immunosuppressive drugs might lead to better understanding of carcinogenesis in general.

De Novo Malignancy After Solid Organ Transplantation in Children

2009 ◽  
Vol 41 (2) ◽  
pp. 674-675 ◽  
Author(s):  
D. Debray ◽  
V. Baudouin ◽  
F. Lacaille ◽  
M. Charbit ◽  
C. Rivet ◽  
...  
Keyword(s):  
Organ Transplantation ◽  
De Novo ◽  
Solid Organ Transplantation ◽  
Solid Organ ◽  
De Novo Malignancy

What Is the Impact of Hypogammaglobulinemia on the Rate of Infections and Survival in Solid Organ Transplantation? A Meta-Analysis

2013 ◽  
Vol 13 (10) ◽  
pp. 2601-2610 ◽  
Author(s):  
D. F. Florescu ◽  
A. C. Kalil ◽  
F. Qiu ◽  
C. M. Schmidt ◽  
U. Sandkovsky
Keyword(s):  
Organ Transplantation ◽  
Meta Analysis ◽  
Solid Organ Transplantation ◽  
Solid Organ ◽  
The Impact

Epidemiology of de novo malignancies after solid-organ transplantation: Immunosuppression, infection and other risk factors

2014 ◽  
Vol 28 (8) ◽  
pp. 1251-1265 ◽  
Author(s):  
Pierluca Piselli ◽  
Diana Verdirosi ◽  
Claudia Cimaglia ◽  
Ghil Busnach ◽  
Lucia Fratino ◽  
...  
Keyword(s):  
Risk Factors ◽  
Organ Transplantation ◽  
De Novo ◽  
Solid Organ Transplantation ◽  
Solid Organ

scholarly journals P202 De novo Inflamatory Bowel Disease after solid organ transplantation

2021 ◽  
Vol 15 (Supplement_1) ◽  
pp. S265-S266
Author(s):  
A M Luque Carmona ◽  
M Rojas Feria ◽  
M D De la Cruz Ramirez ◽  
C Trigo Salado ◽  
J M Herrera Justiniano ◽  
...  
Keyword(s):  
Organ Transplantation ◽  
Bowel Disease ◽  
Biological Therapy ◽  
De Novo ◽  
Solid Organ Transplantation ◽  
Perianal Disease ◽  
Control Group ◽  
Solid Organ ◽  
Extraintestinal Manifestations ◽  
Frequent Change

Abstract Background The aim of this study was to determine the disease phenotype, evolution and therapeutic needs of de novo inflammatory bowel disease (IBD) in transplanted patients. Methods A retrospective single center study that included all patients who developed IBD after solid organ transplantation in a tertiary hospital. Data collected included transplant-related variables, IBD phenotype, course of the disease and its treatment. A control group of non-transplanted IBD patients was randomly selected. Results We included 17 post-transplanted IBD patients and 57 non-transplanted IBD patients. Post-trasplanted patients were older at diagnosis, had greater colonic involvement, with an inflammatory behaviour, absence of perianal involvement and extraintestinal manifestations compared to control group (Table 1). The most common immunosuppression regimen was tacrolimus+mycophenolate mofetil (MMF)+prednisone and the most frequent change after diagnosis was the switch of MMF for azathioprine. De novo IBD patients required less biological therapy than the control group (11.8 vs 42.1% p 0.02) and none required surgical intervention compared to 35.1% in the control group (p 0.002). Multivariate analysis carried out on the total population showed that active smoking, perianal disease and extraintestinal manifestations were associated with a greater need for biologics, while the only factor that influenced surgical risk was stricturing and penetrating behaviour of Crohn′s disease. Conclusion De novo IBD after solid organ transplantation has a favorable course, predominating the inflammatory behaviour and requiring less biological therapy and surgical interventions. The absence of extraintestinal manifestations and perianal disease stands out.

Histopathology and prognosis of de novo bladder tumors following solid organ transplantation

2015 ◽  
Vol 33 (12) ◽  
pp. 2087-2093 ◽  
Author(s):  
Ines A. Ederer ◽  
Ilaria Lucca ◽  
Sebastian L. Hofbauer ◽  
Michael Haidinger ◽  
Andrea Haitel ◽  
...  
Keyword(s):  
Organ Transplantation ◽  
De Novo ◽  
Solid Organ Transplantation ◽  
Solid Organ ◽  
Bladder Tumors
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