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Secondary Prevention of Skin Cancer After Kidney Transplantation: Comparison of Two Strategies

By: Sarah Campen, PharmD
Posted: Friday, February 19, 2021

Two different strategies for secondary prevention of non-melanoma skin cancer after kidney transplantation appear to yield similar outcomes, according to a retrospective study published in Clinical Transplantation. In a cohort of kidney transplant recipients with at least one post-transplant non-melanoma skin cancer who received calcineurin inhibitor–based immunosuppression, the conversion to a regimen of everolimus and a calcineurin inhibitor at a reduced dose showed similar rates of new non-melanoma skin cancer compared with the conversion to a regimen of sirolimus and mycophenolic acid, reported Lionel Couzi, MD, PhD, of the University of Bordeaux and Pellegrin Hospital, France, and colleagues.

This pilot study compared the occurrence of newly diagnosed non-melanoma skin cancers in two cohorts of kidney transplant recipients with at least one non-melanoma skin cancer. A total of 35 patients were converted to everolimus with reduced exposure to a calcineurin inhibitor, and 46 patients were converted to sirolimus plus mycophenolic acid.

A total of 2 years after conversion, the rate of survival free of new non-melanoma skin cancer was similar between the two cohorts (P = .37), with 19 patients (54.3%) in the everolimus group and 22 (47.8%) in the sirolimus group being diagnosed with at least one new non-melanoma skin cancer. As for safety, the incidence of de novo donor-specific antibodies and rejection was low with both strategies. Approximately half of the kidney transplant recipients from both groups experienced adverse events, leading to everolimus discontinuation for 37.1% of patients in the calcineurin inhibitor/everolimus group and sirolimus discontinuation in 21.7% of patients in the sirolimus/mycophenolic acid group (P = .09).

Disclosure: The authors reported no conflicts of interest.



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