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. 2022 Jan 4;11(1):249.
doi: 10.3390/jcm11010249.

Everolimus Reduces Cancer Incidence and Improves Patient and Graft Survival Rates after Kidney Transplantation: A Multi-Center Study

Ryoichi Imamura  1 , Ryo Tanaka  1 , Ayumu Taniguchi  1 , Shigeaki Nakazawa  1 , Taigo Kato  1 , Kazuaki Yamanaka  1 , Tomoko Namba-Hamano  2 , Yoichi Kakuta  3 , Toyofumi Abe  1 , Koichi Tsutahara  3 , Tetsuya Takao  3 , Hidefumi Kishikawa  4 , Norio Nonomura  1
Affiliations

Everolimus Reduces Cancer Incidence and Improves Patient and Graft Survival Rates after Kidney Transplantation: A Multi-Center Study

Ryoichi Imamura et al. J Clin Med. .

Abstract

Kidney transplantation can prevent renal failure and associated complications in patients with end-stage renal disease. Despite the good quality of life, de novo cancers after kidney transplantation are a major complication impacting survival and there is an urgent need to establish immunosuppressive protocols to prevent de novo cancers. We conducted a multi-center retrospective study of 2002 patients who underwent kidney transplantation between 1965 and 2020 to examine patient and graft survival rates and cumulative cancer incidence in the following groups categorized based on specific induction immunosuppressive therapies: group 1, antiproliferative agents and steroids; group 2, calcineurin inhibitors (CNIs), antiproliferative agents and steroids; group 3, CNIs, mycophenolate mofetil, and steroids; and group 4, mammalian target of rapamycin inhibitors including everolimus, CNIs, mycophenolate mofetil, and steroids. The patient and graft survival rates were significantly higher in groups 3 and 4. The cumulative cancer incidence rate significantly increased with the use of more potent immunosuppressants, and the time to develop cancer was shorter. Only one patient in group 4 developed de novo cancer. Potent immunosuppressants might improve graft survival rate while inducing de novo cancer after kidney transplantation. Our data also suggest that everolimus might suppress cancer development after kidney transplantation.

Keywords: cumulative incidence; de novo cancer; everolimus; kidney transplantation; mammalian target of rapamycin; survival.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
A diagram describing the study population.
Figure 2
Figure 2
Cumulative cancer incidence rates after kidney transplantation. (a) all cancers, (b) all cancers except non-melanoma skin cancer: Blue, group 1; green, group 2; dark red, group 3; vermilion, group 4.
Figure 3
Figure 3
(a) Overall and (b) cancer-specific survival rates after kidney transplantation: Blue, group 1; green, group 2; dark red, group 3; vermilion, group 4.
Figure 4
Figure 4
Death-censored graft survival rates after kidney transplantation: Blue, group 1; green, group 2; dark red, group 3; vermilion, group 4.
See this image and copyright information in PMC

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