Proliferation signal inhibitors and post-transplant malignancies in heart transplantation: Practical clinical management questions

E. Epailly, J. Albanell, A. Andreassen, C. Bara, J. M. Campistol, J. F. Delgado, H. Eisen, A. E. Fiane, P. Mohacsi, S. Schubert, L. Sebbag, F. M. Turazza, H. Valantine, A. Zuckermann, L. Potena

Research output: Contribution to journalReview article

16 Citations (Scopus)

Abstract

Although malignancy is a major threat to long-term survival of heart transplant (HT) recipients, clear strategies to manage immunosuppression in these patients are lacking. Several lines of evidences support the hypothesis of an anticancer effect of proliferation signal inhibitors (PSIs: mammalian target of rapamycin [mTOR] inhibitors) in HT recipients. This property may arise from PSI's ability to replace immunosuppressive therapies that promote cancer progression, such as calcineurin inhibitors or azathioprine, and/or through their direct biological actions in preventing tumor development and progression. Given the lack of randomized studies specifically exploring these issues in the transplant setting, a collaborative group reviewed current literature and personal clinical experience to reach a consensus aimed to provide practical guidance for the clinical conduct in HT recipients with malignancy, or at high risk of malignancy, with a special focus on advice relevant to potential role of PSIs.

Original languageEnglish (US)
Pages (from-to)E475-E486
JournalClinical Transplantation
Volume25
Issue number5
DOIs
StatePublished - Sep 1 2011

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Heart Transplantation
Transplants
Neoplasms
Azathioprine
Sirolimus
Immunosuppressive Agents
Immunosuppression
Transplant Recipients

All Science Journal Classification (ASJC) codes

  • Transplantation

Cite this

Epailly, E. ; Albanell, J. ; Andreassen, A. ; Bara, C. ; Campistol, J. M. ; Delgado, J. F. ; Eisen, H. ; Fiane, A. E. ; Mohacsi, P. ; Schubert, S. ; Sebbag, L. ; Turazza, F. M. ; Valantine, H. ; Zuckermann, A. ; Potena, L. / Proliferation signal inhibitors and post-transplant malignancies in heart transplantation : Practical clinical management questions. In: Clinical Transplantation. 2011 ; Vol. 25, No. 5. pp. E475-E486.
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Epailly, E, Albanell, J, Andreassen, A, Bara, C, Campistol, JM, Delgado, JF, Eisen, H, Fiane, AE, Mohacsi, P, Schubert, S, Sebbag, L, Turazza, FM, Valantine, H, Zuckermann, A & Potena, L 2011, 'Proliferation signal inhibitors and post-transplant malignancies in heart transplantation: Practical clinical management questions', Clinical Transplantation, vol. 25, no. 5, pp. E475-E486. https://doi.org/10.1111/j.1399-0012.2011.01476.x

Proliferation signal inhibitors and post-transplant malignancies in heart transplantation : Practical clinical management questions. / Epailly, E.; Albanell, J.; Andreassen, A.; Bara, C.; Campistol, J. M.; Delgado, J. F.; Eisen, H.; Fiane, A. E.; Mohacsi, P.; Schubert, S.; Sebbag, L.; Turazza, F. M.; Valantine, H.; Zuckermann, A.; Potena, L.

In: Clinical Transplantation, Vol. 25, No. 5, 01.09.2011, p. E475-E486.

Research output: Contribution to journalReview article

TY - JOUR

T1 - Proliferation signal inhibitors and post-transplant malignancies in heart transplantation

T2 - Practical clinical management questions

AU - Epailly, E.

AU - Albanell, J.

AU - Andreassen, A.

AU - Bara, C.

AU - Campistol, J. M.

AU - Delgado, J. F.

AU - Eisen, H.

AU - Fiane, A. E.

AU - Mohacsi, P.

AU - Schubert, S.

AU - Sebbag, L.

AU - Turazza, F. M.

AU - Valantine, H.

AU - Zuckermann, A.

AU - Potena, L.

PY - 2011/9/1

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AB - Although malignancy is a major threat to long-term survival of heart transplant (HT) recipients, clear strategies to manage immunosuppression in these patients are lacking. Several lines of evidences support the hypothesis of an anticancer effect of proliferation signal inhibitors (PSIs: mammalian target of rapamycin [mTOR] inhibitors) in HT recipients. This property may arise from PSI's ability to replace immunosuppressive therapies that promote cancer progression, such as calcineurin inhibitors or azathioprine, and/or through their direct biological actions in preventing tumor development and progression. Given the lack of randomized studies specifically exploring these issues in the transplant setting, a collaborative group reviewed current literature and personal clinical experience to reach a consensus aimed to provide practical guidance for the clinical conduct in HT recipients with malignancy, or at high risk of malignancy, with a special focus on advice relevant to potential role of PSIs.

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DO - 10.1111/j.1399-0012.2011.01476.x

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