Effect of everolimus on skin cancers in calcineurin inhihitor-treated heart transplant recipients

The MANDELA study: A multicenter, randomized, open-label, parallel group trial to refine the use of everolimus after heart transplantation

“…There is preliminary data to suggest that heart transplant patients with nonmelanoma skin cancer who are converted to everolimus develop fewer subsequent tumors. 39 One observational single-center study has described a significantly lower risk of noncutaneous neoplasia after switch from CNI to an mTOR inhibitor 40 but this is unconfirmed. While promising, more data are required.…”

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“…5 This rare genodermatosis can be hardly unmasked after a transplant and the relative immunosuppressive therapies, thus resulting in many diagnostic problems. [2][3] A previous report showed the case of a transplant patient with sebaceous neoplasms (after cyclosporine and tacrolimus treatments), who received the diagnosis of unmasked MTS, presenting only an aberration in mismatch repair genes and a lack of internal malignancies. This evidence highlights the high probability of unmasked MTS in transplant recipients under immunosuppressive treatments.…”

“…Regardless, this rare genodermatosis can be hardly unmasked after a transplant, resulting in many diagnostic problems for pathologists as well as the clinicians. [2][3] In recent times, evidence of resolution of multiple cutaneous neoplasms in transplant patients under treatment with everolimus, has marked an important stage in the role of proliferation signal inhibitors in this class of patients. 3 We report the case of a transplant patient with multiple sebaceous neoplasms, who successfully regressed after switching the therapy with everolimus.…”

Everolimus immunosuppression in kidney transplantation: What is the optimal strategy?

“…Since the nephrotoxicity associated with CNI agents does not occur under mTOR inhibitors, a key goal is to avoid chronic CNI-related histological damage to the graft. In addition, there is increasing interest in other potential benefits of mTOR inhibitor therapy relating to its antiproliferative activity, notably reducing tumor growth and de novo malignancies [3,[6][7][8], its cardioprotective effects [3,[9][10][11] and evidence for a lower frequency of cytomegalovirus (CMV) infections [12].…”