Patients taking sirolimus after developing posttransplant cancer had a reduced risk for developing subsequent skin cancer, with no elevated risk for overall mortality, a study published in JAMA Dermatology has shown.1
Solid-organ transplant recipients (OTRs) are at an increased risk for developing skin cancer, but previous research has demonstrated decreased incidence of skin cancer in renal OTRs treated with the immunosuppressant agent sirolimus.
Therefore, researchers sought to compare skin cancer formation in a cohort of OTRs who have undergone renal, heart, lung, or liver transplant and were or were not treated with sirolimus after developing a posttransplant-related cancer.
For the retrospective study, researchers analyzed data from 329 OTR with an index posttransplant cancer who received care at 2 academic tertiary care centers between January 1, 2000 and December 31, 2008.
Results showed that 97 OTRs underwent conversion to sirolimus therapy following cancer diagnosis. Researchers found that 130 patients developed second posttransplant cancers, of which 88.5% were skin cancers.
The study demonstrated sirolimus use was associated with an 11.6% reduction in skin cancer risk compared with non-sirolimus-treated patients (P = .045). Risk factors of subsequent skin cancer formation included history of pretransplant skin cancer, skin cancer as the index posttransplant cancer, and sirolimus treatment.
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“Conversion to sirolimus therapy may be considered in OTRs who develop cancer if the risk for skin cancer is of concern,” the authors concluded. “Larger studies are needed to quantify sirolimus-associated risk reduction for other cancer types.”
- Karia PS, Azzi JR, Heher, et al. Association of sirolimus use with risk for skin cancer in a mixed-organ cohort of solid-organ transplant recipients with a history of cancer [published online ahead of print January 20, 2016]. JAMA Dermatol. doi: 10.1001/jamadermatol.2015.5548.