Oncotarget

Clinical Research Papers:

Conversion to mammalian target of rapamycin inhibitors in kidney transplant recipients with de novo cancers

Chi Yuen Cheung, Maggie Kam Man Ma, Wai Leung Chak, Ka Foon Chau and Sydney Chi Wai Tang _

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Oncotarget. 2017; 8:44833-44841. https://doi.org/10.18632/oncotarget.14908

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Abstract

Chi Yuen Cheung1, Maggie Kam Man Ma2 , Wai Leung Chak1, Ka Foon Chau1 and Sydney Chi Wai Tang2

1 Department of Medicine, Renal Unit, Queen Elizabeth Hospital, Yau Ma Tei, Hong Kong SAR

2 Department of Medicine, Division of Nephrology, The University of Hong Kong, Queen Mary Hospital, Yau Ma Tei, Hong Kong SAR

Correspondence to:

Sydney Chi Wai Tang, email:

Keywords: cancer, everolimus, kidney transplant, sirolimus

Received: December 12, 2016 Accepted: January 17, 2017 Published: January 30, 2017

Abstract

Objective: To investigate the impact of mammalian target of rapamycin (mTOR) inhibitor conversion together with minimization of calcineurin inhibitor on allograft outcome and patient survival in kidney transplant recipients with post-transplant cancers.

Methods: A retrospective study of all kidney transplant recipients diagnosed to have post-transplant cancers between the period 1/1/1994 and 30/6/2015. Patients were divided into 2 groups: mTOR inhibitor group and non-conversion group. Outcome included allograft function, patient survival, graft survival, acute rejection and cancer recurrence.

Results: 115 patients (56 in mTOR inhibitor group and 59 in non-conversion group) were analyzed. Median follow up was 28 months (range: 1 month – 20 years). The allograft function at 1-year remained similar between both groups. There was no significant difference in the patient survival, graft survival and rejection free survival between both groups. More patients in the non-conversion group developed recurrence of cancers than mTOR inhibitor group but statistically not significant.

Conclusions: Use of mTOR inhibitors together with calcineurin inhibitor minimization offer a reasonable option in kidney transplant recipients who developed post-transplant cancers in view of stable renal function, low rejection rate and low cancer recurrence rate.


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