Related Experiment Video
Updated: Jul 10, 2026
Murine Full-thickness Skin Transplantation
Published on: January 2, 2017
Anticancer effect of sirolimus in renal allograft recipients with de novo malignancies
M Boratyńska1, E Watorek, D Smolska
1Department of Nephrology and Transplantation Medicine, Wroclaw Medical University, Wroclaw, Poland. maria.boratynska@poczta.onet.pl
Abstract:
The inhibition of mTOR is a target for anticancer drugs in posttransplant malignancies. The influence of conversion to sirolimus after malignancy diagnosis was investigated on patient and renal allograft survivals. The 20 renal allograft recipients (4 women, 16 men) of ages 26 to 73 years (mean, 59 years) developed malignancies within 6 to 172 months (mean, 53 months) after transplantation. Three patients developed posttransplant lymphoproliferative disease (PTLD); four, Kaposi sarcoma, three, lung cancer; two, malignant melanoma; two, breast cancer; two, renal cell carcinoma; one, Merkel cell carcinoma; one, cutaneous T-cell lymphoma; one, larynx cancer; and one, gingival cancer. After tumor diagnosis, calcineurin inhibitors, azathioprine, or mycophenolate mofetil (MMF) were discontinued abruptly and sirolimus introduced (2 mg/d; target trough level, 4.0 to 8.0 ng/mL). Prednisone was maintained. The observation time of sirolimus therapy was 4 to 48 months (mean, 14 months). Two patients with PTLD (large B-cell lymphoma) and four with Kaposi sarcoma had full regressions. Eleven patients (larynx cancer, melanoma, breast cancer, T-cell lymphoma, renal cell carcinoma, Merkel cell carcinoma, and skin lymphoma) in addition to sirolimus therapy, underwent oncologic treatment, namely, surgery and/or chemotherapy. Six patients died from disseminated malignancy 4 to 9 months after conversion. One patient with T-cell lymphoma lost his graft; in the remaining patients, serum creatinine level was stable. In conclusion, Conversion to sirolimus resulted in regression of large B-cell lymphoma and Kaposi sarcoma. In patients with advanced or disseminated malignancy, the tumors progressed. Graft function was preserved after conversion to sirolimus.
Insights
Converting to sirolimus after cancer diagnosis in transplant patients showed tumor regression in some cases, particularly for PTLD and Kaposi sarcoma. However, advanced malignancies still progressed, though graft function was preserved.
Area of Science:
- Oncology
- Nephrology
- Transplantation
Background:
- Post-transplant malignancies are a significant concern in renal allograft recipients.
- Mammalian target of rapamycin (mTOR) inhibition is a therapeutic strategy for certain cancers.
Purpose of the Study:
- To investigate the impact of switching to sirolimus on patient survival and renal allograft outcomes in patients diagnosed with post-transplant malignancies.
- To assess the efficacy of sirolimus in managing various types of cancers that arise after organ transplantation.
Main Methods:
- Retrospective analysis of 20 renal allograft recipients who developed malignancies.
- Discontinuation of calcineurin inhibitors, azathioprine, or mycophenolate mofetil (MMF) and initiation of sirolimus therapy.
- Monitoring of patient and graft survival, tumor response, and renal function (serum creatinine levels).
Main Results:
- Complete regression of post-transplant lymphoproliferative disease (PTLD) and Kaposi sarcoma observed in responding patients.
- Tumor progression occurred in patients with advanced or disseminated malignancies.
- Renal allograft function remained stable in most patients after conversion to sirolimus.
Conclusions:
- Conversion to sirolimus can induce regression of specific malignancies like PTLD and Kaposi sarcoma in transplant recipients.
- Sirolimus therapy appears to preserve renal allograft function.
- Outcomes for advanced or disseminated malignancies remain poor despite sirolimus conversion.
