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Rapamycin Inhibitors for Eye Squamous Cell Carcinoma after Renal Transplantation: A Case Report
Barbara Infante1, Nicola Coviello1, Dario Troise1
1Department of Medical and Surgical Sciences, Nephrology, Dialysis and Transplantation Unit, University of Foggia, Foggia, Italy.
Introduction:
The immunosuppressive efficiency obtained in the last decades in kidney transplantation significantly improved graft survival. However, there is still a high risk and incidence of cancer in transplant patients strongly and directly related to the type of immunosuppression. An increasing body of evidence suggests that the PI3K/Akt/mTOR pathway may play a pivotal role in the development and progression of several neoplastic diseases.
Case Presentation:
We describe a 47-year-old male patient who received a cadaveric primary renal transplant in November 2008 developing a poorly differentiated infiltrating and ulcerated squamous cell carcinoma (SCC) at the eye level. In this patient, the modification of an immunosuppressive regimen with introduction of rapamycin (mTOR) inhibitors and withdrawal of calcineurin inhibitors (CNIs) led to the resolution of this severe condition.
Conclusion:
The introduction of mTOR inhibitors and withdrawal of CNIs in kidney-transplanted patients with de novo eye SCC should be considered in this clinical setting.
Insights
Switching immunosuppression to mTOR inhibitors resolved squamous cell carcinoma in a kidney transplant patient. This highlights a potential strategy for managing de novo cancers post-transplant.
Area of Science:
- Oncology
- Transplantation Immunology
- Molecular Biology
Background:
- Kidney transplantation success has increased, but cancer risk remains high, linked to immunosuppression.
- The PI3K/Akt/mTOR pathway is implicated in various cancers.
- Specific immunosuppressive drugs may influence cancer development in transplant recipients.
Observation:
- A 47-year-old male kidney transplant recipient developed aggressive squamous cell carcinoma (SCC) on his face.
- The patient's immunosuppressive regimen was altered, replacing calcineurin inhibitors (CNIs) with mTOR inhibitors.
Findings:
- The switch to mTOR inhibitors led to the complete resolution of the de novo SCC.
- This suggests a direct impact of immunosuppression modulation on cancer regression.
Implications:
- Modifying immunosuppression by introducing mTOR inhibitors and withdrawing CNIs may be a viable strategy for treating de novo cancers in kidney transplant patients.
- Further research is warranted to explore this therapeutic approach in similar clinical scenarios.
