PMID- 26483298
OWN - NLM
STAT- MEDLINE
DCOM- 20160321
LR  - 20181113
IS  - 1759-4782 (Electronic)
IS  - 1759-4774 (Linking)
VI  - 12
IP  - 12
DP  - 2015 Dec
TI  - Post-transplantation malignancies: here today, gone tomorrow?
PG  - 705-17
LID - 10.1038/nrclinonc.2015.186 [doi]
AB  - From the early days of transplantation onwards, increased cancer development in 
      transplant recipients, who require immunosuppression to avoid graft rejection, 
      has been recognized. Registry data indicate that approximately 10-30% of deaths 
      are attributed to post-transplant malignancy, with an upward trend in this 
      incidence as more patients have been exposed to chronic lifelong 
      immunosuppression. In this Review, the overall incidence and most frequent types 
      of cancer encountered are summarized, along with information about which 
      transplant recipients are at the greatest risk of malignancy. Reasons for why 
      differences exist in susceptibility to cancer in this patient population are 
      examined, and approaches that might improve our understanding of the options 
      available for reducing the incidence of this adverse effect of immunosuppression 
      are described. Whether anti-rejection drugs have been successful in diminishing 
      overall immunosuppressive burden, and consequently show any promise for 
      decreasing post-transplant malignancies is also discussed. The topic shifts to 
      one class of conventional anti-rejection drugs, the mammalian target of rapamycin 
      (mTOR) inhibitors, which paradoxically have both immunosuppressive and 
      anti-neoplastic properties. The complex activities of mTOR are reviewed in order 
      to provide context for how these seemingly opposing effects are possible, and the 
      latest clinical data on use of mTOR inhibitors in the clinic are discussed. The 
      current and future perspectives on how best to normalize these unacceptably high 
      rates of post-transplantation malignancies are highlighted.
FAU - Geissler, Edward K
AU  - Geissler EK
AD  - Department of Surgery, Section of Experimental Surgery, University Hospital 
      Regensburg, Franz-Josef-Strauss-Allee 11, Regensburg 93053, Germany.
LA  - eng
PT  - Journal Article
PT  - Review
DEP - 20151020
PL  - England
TA  - Nat Rev Clin Oncol
JT  - Nature reviews. Clinical oncology
JID - 101500077
RN  - 0 (Immunosuppressive Agents)
SB  - IM
MH  - Humans
MH  - Immunosuppressive Agents/*adverse effects
MH  - Neoplasms/*chemically induced
MH  - *Organ Transplantation
MH  - Postoperative Complications/*chemically induced
EDAT- 2015/10/21 06:00
MHDA- 2016/03/22 06:00
CRDT- 2015/10/21 06:00
PHST- 2015/10/21 06:00 [entrez]
PHST- 2015/10/21 06:00 [pubmed]
PHST- 2016/03/22 06:00 [medline]
AID - nrclinonc.2015.186 [pii]
AID - 10.1038/nrclinonc.2015.186 [doi]
PST - ppublish
SO  - Nat Rev Clin Oncol. 2015 Dec;12(12):705-17. doi: 10.1038/nrclinonc.2015.186. Epub 
      2015 Oct 20.