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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.
J Heart Lung Transplant. 2007 Jun; 26(6):557-64.JH

Abstract

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.

Authors+Show Affiliations

Falk Cardiovascular Research Center, Stanford University Medical School, Stanford, California 94305, USA. hvalantine@stanford.edu

Pub Type(s)

Journal Article

Language

eng

PubMed ID

17543777

Citation

Valantine, Hannah. "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." The Journal of Heart and Lung Transplantation : the Official Publication of the International Society for Heart Transplantation, vol. 26, no. 6, 2007, pp. 557-64.
Valantine H. 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. J Heart Lung Transplant. 2007;26(6):557-64.
Valantine, H. (2007). 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. The Journal of Heart and Lung Transplantation : the Official Publication of the International Society for Heart Transplantation, 26(6), 557-64.
Valantine H. 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. J Heart Lung Transplant. 2007;26(6):557-64. PubMed PMID: 17543777.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - 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. A1 - Valantine,Hannah, PY - 2006/10/28/received PY - 2007/03/12/revised PY - 2007/03/12/accepted PY - 2007/6/5/pubmed PY - 2007/8/19/medline PY - 2007/6/5/entrez SP - 557 EP - 64 JF - The Journal of heart and lung transplantation : the official publication of the International Society for Heart Transplantation JO - J Heart Lung Transplant VL - 26 IS - 6 N2 - 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. SN - 1557-3117 UR - https://www.unboundmedicine.com/medline/citation/17543777/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_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S1053-2498(07)00259-8 DB - PRIME DP - Unbound Medicine ER -