Optimal oncologic management and mTOR inhibitor introduction are safe and improve survival in kidney and liver allograft recipients with de novo carcinoma

International Journal of Cancer. Journal International Du Cancer
Benoît RousseauChristophe Tournigand

Abstract

Prognosis and oncologic treatment feasibility in solid organ transplant patients with de novo cancer remain poorly described. We investigated the impact of immunosuppressive therapy modifications after de novo cancer diagnosis on oncologic treatment feasibility, toxicities, and prognosis. Patients with de novo cancer (excluding nonmelanoma skin cancers) were selected from a monocentric cohort of 4,637 kidney and liver allograft recipients. We assessed oncologic treatment optimality according to guidelines and analyzed immunosuppressive drug modifications and oncologic treatment impacts on treatment feasibility, toxicities, and graft/patient survivals. A total of 180 patients with 205 cancers were included: mean age 60 years, median delay from transplantation to first de novo cancer 5 years. In 46% of cases, immunosuppressive therapy was modified after cancer diagnosis: 24% dose reduction and 22% mTOR inhibitor introduction. Optimal oncologic treatment was performed in 80% and 38% of patients with localized and advanced cancer respectively. Transplantation and immunosuppression hindered optimal oncologic treatment in 11% instances. Immunosuppressive therapy modifications did not affect oncologic treatment tolerance nor graft sur...Continue Reading

References

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Citations

Jun 19, 2019·Transplant International : Official Journal of the European Society for Organ Transplantation·Tor Magnus SmedmanSvein Dueland
May 11, 2019·Oncotarget·Benoit RousseauChristophe Tournigand
Nov 10, 2020·Frontiers in Immunology·Rossana FranzinElena Ranieri
Jul 9, 2021·Transplantation Reviews·Jacopo RomagnoliUNKNOWN Consensus Conference Expert Panel
Mar 21, 2021·Transplantation·Dag Olav DahleKarsten Midtvedt
Dec 17, 2021·Current Urology Reports·Cristian Axel Hernández-GaytánAna María Autrán-Gómez

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