The researchers found that liver transplant recipients were at increased risk of dying from post-transplant denovo liver cancers. They also found that only kidney recipients were at increased risk of mortality from leukemia, melanoma, colorectal, oral cavity/pharynx, and prostate cancer.

The investigators noted that a tailored approach to cancer screening may be required for SOTRs. Kidney recipients should be especially cautioned to take all available steps to prevent skin cancer. Dr Baxter said skin cancer is a major concern in this patient population.


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“Screening can really help for preventing poor outcomes of skin malignancies,” Dr Baxter told Cancer Therapy Advisor. “Oncologists should be aware that these patients are not only at increased risk of developing skin malignancies, but also at increased risk of dying of cancer.”

Dr Acuna said it is important that clinicians involved in the care of transplant recipients follow the current recommendations for cancer screenings in SOTRs.

He also said clinicians should start cancer screenings early after transplantation and have a high level of suspicion to identify malignancies at earlier stages.

Dr Acuna said clinicians involved in the care of transplant recipients should counsel them to take every possible precaution to reduce their cancer risk, including limiting sun exposure, quitting smoking, reducing alcohol consumption, improving their diet, and increasing their physical activity.

Medical oncologist Khaled Tolba, MD, who is an assistant professor at Oregon Health & Science University, Portland, OR, said this is a very important study because it demonstrated specific types of cancer that may pose a greater risk in SOTRs. He said immune suppression strategies are improving and this may also affect cancer risk among SOTRs in the coming years.

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“The immune suppression will expose the patient to several viral infections and some of them might be oncogenic and lead to skin cancer or other solid tumors. In a normal person, the viral infection will get cleared but that is not the case with solid organ transplant recipients,” Dr Tolba said in an interview with Cancer Therapy Advisor.

“This is definitely a concern and it is has been known for a long time. However, we are learning more about the immune suppression and we might be able to better manipulate it to prevent the problem posed by viral infections.”

Reference

  1. Acuna SA, Fernandes KA, Daly C, et al. Cancer mortality among recipients of solid-organ transplantation in Ontario, Canada [published online ahead of print January 7, 2016]. JAMA Oncol. doi: 10.1001/jamaoncol.2015.5137.