PMID- 17543777
OWN - NLM
STAT- MEDLINE
DCOM- 20070817
LR  - 20211203
IS  - 1557-3117 (Electronic)
IS  - 1053-2498 (Linking)
VI  - 26
IP  - 6
DP  - 2007 Jun
TI  - Is there a role for proliferation signal/mTOR inhibitors in the prevention and 
      treatment of de novo malignancies after heart transplantation? Lessons learned 
      from renal transplantation and oncology.
PG  - 557-64
AB  - With the development of new immunosuppressive agents, the majority of transplant 
      recipients are surviving for over a decade, and malignancy has become a major 
      burden on long-term survival. Reducing the incidence of post-transplant 
      malignancies is especially important in heart transplantation where the risk of 
      malignancies is higher than in other organ transplants. Everolimus and sirolimus, 
      the proliferation signal inhibitors (PSIs) or mammalian target-of-rapamycin 
      (mTOR) inhibitors, now provide new strategies for immunosuppression because of 
      their proven efficacy that translates to a reduction in doses of calcineurin 
      inhibitors needed to prevent acute rejection. In addition, the anti-proliferative 
      effects of this class of drugs raise the possibility that they may be effective 
      for reducing the risk of malignancies after solid-organ transplantation. Despite 
      the paucity of direct clinical evidence for this effect in heart transplant 
      patients, observations from renal transplant recipients suggest that the 
      anti-proliferative actions of PSIs/mTOR inhibitors may also protect against 
      malignancies in heart transplant recipients. This potential for an anti-cancer 
      effect is further supported by the emerging data on the use of PSIs/mTOR 
      inhibitors in non-transplant oncology patients. Reviewed in this article are the 
      incidence rates of malignancies after solid-organ transplantation, and the 
      evidence for anti-cancer effects of PSIs/mTOR inhibitors in renal transplant 
      recipients and in non-transplant patients. Also discussed are the implications of 
      these observational data for future studies on the reduction of malignancies 
      after heart transplantation.
FAU - Valantine, Hannah
AU  - Valantine H
AD  - Falk Cardiovascular Research Center, Stanford University Medical School, 
      Stanford, California 94305, USA. hvalantine@stanford.edu
LA  - eng
PT  - Journal Article
PL  - United States
TA  - J Heart Lung Transplant
JT  - The Journal of heart and lung transplantation : the official publication of the 
      International Society for Heart Transplantation
JID - 9102703
RN  - 0 (Enzyme Inhibitors)
RN  - 0 (Immunosuppressive Agents)
RN  - 83HN0GTJ6D (Cyclosporine)
RN  - EC 2.7.- (Protein Kinases)
RN  - EC 2.7.1.1 (MTOR protein, human)
RN  - EC 2.7.11.1 (TOR Serine-Threonine Kinases)
RN  - MRK240IY2L (Azathioprine)
RN  - WM0HAQ4WNM (Tacrolimus)
SB  - IM
MH  - Azathioprine/adverse effects
MH  - Cyclosporine/adverse effects
MH  - Enzyme Inhibitors/*adverse effects
MH  - Heart Transplantation/*adverse effects
MH  - Humans
MH  - Immunosuppressive Agents/*adverse effects
MH  - Kidney Transplantation/*adverse effects
MH  - Neoplasms/*epidemiology/*prevention & control
MH  - Postoperative Complications/epidemiology
MH  - Protein Kinases/*metabolism
MH  - Risk
MH  - Risk Factors
MH  - TOR Serine-Threonine Kinases
MH  - Tacrolimus/adverse effects
EDAT- 2007/06/05 09:00
MHDA- 2007/08/19 09:00
CRDT- 2007/06/05 09:00
PHST- 2006/10/28 00:00 [received]
PHST- 2007/03/12 00:00 [revised]
PHST- 2007/03/12 00:00 [accepted]
PHST- 2007/06/05 09:00 [pubmed]
PHST- 2007/08/19 09:00 [medline]
PHST- 2007/06/05 09:00 [entrez]
AID - S1053-2498(07)00259-8 [pii]
AID - 10.1016/j.healun.2007.03.010 [doi]
PST - ppublish
SO  - J Heart Lung Transplant. 2007 Jun;26(6):557-64. doi: 
      10.1016/j.healun.2007.03.010.