Management of Kaposi sarcoma after solid organ transplantation: A European retrospective study.
Adult
Antineoplastic Agents
/ therapeutic use
Antineoplastic Combined Chemotherapy Protocols
/ therapeutic use
Drug Substitution
Europe
Female
Graft Survival
Humans
Immunosuppressive Agents
/ administration & dosage
Male
Middle Aged
Organ Transplantation
/ adverse effects
Retrospective Studies
Sarcoma, Kaposi
/ etiology
Sirolimus
/ therapeutic use
Skin Neoplasms
/ etiology
Survival Rate
TOR Serine-Threonine Kinases
/ antagonists & inhibitors
Tacrolimus
/ therapeutic use
Kaposi sarcoma
chemotherapy
immunosuppression
mTOR inhibitor
organ transplantation
post-transplant malignancies
Journal
Journal of the American Academy of Dermatology
ISSN: 1097-6787
Titre abrégé: J Am Acad Dermatol
Pays: United States
ID NLM: 7907132
Informations de publication
Date de publication:
Aug 2019
Aug 2019
Historique:
received:
13
08
2018
revised:
14
02
2019
accepted:
12
03
2019
pubmed:
25
3
2019
medline:
21
12
2019
entrez:
24
3
2019
Statut:
ppublish
Résumé
Systemic therapeutic management of post-transplant Kaposi sarcoma (KS) is mainly based on 3 axes: reduction of immunosuppression, conversion to mammalian target of rapamycin (mTOR) inhibitors, chemotherapy, or a combination of these. To obtain an overview of clinical strategies about the current treatment of KS. We conducted a multicenter retrospective cohort study including 145 solid organ transplant recipients diagnosed with KS between 1985 and 2011 to collect data regarding first-line treatment and response at 6 months. Overall, 95%, 28%, and 16% of patients had reduction of immunosuppression, conversion to mTOR inhibitor, and chemotherapy, respectively. Patients treated with chemotherapy or mTOR inhibitor conversion were more likely to have visceral KS. At 6 months, 83% of patients had response, including 40% complete responses. The retrospective design of the study. Currently available therapeutic options seem to be effective to control KS in most patients. Tapering down the immunosuppressive regimen remains the cornerstone of KS management.
Sections du résumé
BACKGROUND
BACKGROUND
Systemic therapeutic management of post-transplant Kaposi sarcoma (KS) is mainly based on 3 axes: reduction of immunosuppression, conversion to mammalian target of rapamycin (mTOR) inhibitors, chemotherapy, or a combination of these.
OBJECTIVE
OBJECTIVE
To obtain an overview of clinical strategies about the current treatment of KS.
METHODS
METHODS
We conducted a multicenter retrospective cohort study including 145 solid organ transplant recipients diagnosed with KS between 1985 and 2011 to collect data regarding first-line treatment and response at 6 months.
RESULTS
RESULTS
Overall, 95%, 28%, and 16% of patients had reduction of immunosuppression, conversion to mTOR inhibitor, and chemotherapy, respectively. Patients treated with chemotherapy or mTOR inhibitor conversion were more likely to have visceral KS. At 6 months, 83% of patients had response, including 40% complete responses.
LIMITATIONS
CONCLUSIONS
The retrospective design of the study.
CONCLUSION
CONCLUSIONS
Currently available therapeutic options seem to be effective to control KS in most patients. Tapering down the immunosuppressive regimen remains the cornerstone of KS management.
Identifiants
pubmed: 30902727
pii: S0190-9622(19)30442-6
doi: 10.1016/j.jaad.2019.03.028
pii:
doi:
Substances chimiques
Antineoplastic Agents
0
Immunosuppressive Agents
0
TOR Serine-Threonine Kinases
EC 2.7.11.1
Sirolimus
W36ZG6FT64
Tacrolimus
WM0HAQ4WNM
Types de publication
Journal Article
Multicenter Study
Langues
eng
Sous-ensembles de citation
IM
Pagination
448-455Informations de copyright
Copyright © 2019 American Academy of Dermatology, Inc. Published by Elsevier Inc. All rights reserved.