Why is the high risk of skin cancer in organ transplant recipients declining?

Gjersvik, Petter

doi:10.1111/bjd.18432

Cited by 2 publications

(2 citation statements)

References 13 publications

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“…11,12 The immunosuppressive actions of these drugs have a well-documented list of side-effects and toxicities due to the non-specific nature of immunesuppression. 13,14 It is well-established that the immune system has an important role in the progression and regression of melanoma, and therefore it is likely that the development of this cancer is affected by long-term exposure to immunomodulating drugs. 15 Organ transplant recipients (OTRs) are shown to experience an increased risk of melanoma, [16][17][18][19] though such a relationship is not clear for other patient groups who use immunosuppressant drugs.…”

Section: Introductionmentioning

confidence: 99%

<p>Use of Immunomodulating Drugs and Risk of Cutaneous Melanoma: A Nationwide Nested Case-Control Study</p>

Berge

Andreassen

Stenehjem

et al. 2020

CLEP

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Purpose Cutaneous melanoma is among the fastest growing malignancies in Norway and ultraviolet radiation (UVR) exposure is the primary environmental risk factor. Immunomodulating drugs can increase skin photosensitivity and suppress immune responses, and by such mechanisms influence melanoma risk. We, therefore, aimed to examine the associations between use of immunomodulating drugs and melanoma risk, at a nationwide population level. Patients and Methods In the Cancer Registry of Norway, we identified all cases aged 18–85 with a first primary cutaneous melanoma diagnosed in 2007–2015 (n=12,106). These were matched to population controls from the Norwegian National Registry 1:10 (n=118,564), on sex and year of birth using risk set sampling. Information on prescribed drugs (2004–2015) was obtained by linkage to the Norwegian Prescription Database (NorPD). Conditional logistic regression was used to estimate rate ratios (RRs) and 95% confidence intervals (CIs) for associations between use of immunomodulating drugs (immunosuppressants and corticosteroids) and melanoma risk, adjusted for ambient UVR and other drug use. Results Compared with ≤1 prescription, use of ≥8 prescriptions of immunosuppressants was associated with increased risk of melanoma (RR 1.50, 95% CI 1.27, 1.77). Similar associations were found for subgroups of immunosuppressants: drugs typically prescribed to organ transplant recipients (OTRs) (RR 2.02, 95% CI 1.35, 3.03) and methotrexate (RR 1.27, 95% CI 1.04, 1.55). Similar results were found for high levels of cumulative doses and across all histological subtypes. Use of corticosteroids was not associated with melanoma risk. Conclusion We found a positive association between use of immunosuppressants and melanoma risk, with the highest risk seen for drugs prescribed to OTRs. Knowledge about this risk increase is important for physicians and users of these drugs, for intensified surveillance, awareness and cautious sun exposure.

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Section: Introductionmentioning

confidence: 99%

<p>Use of Immunomodulating Drugs and Risk of Cutaneous Melanoma: A Nationwide Nested Case-Control Study</p>

Berge

Andreassen

Stenehjem

et al. 2020

CLEP

View full text Add to dashboard Cite

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“… 19 The use of certain immunosuppressive medications have also been associated with an increased risk of skin cancer, including calcineurin inhibitors, such as tacrolimus and CsA, as well as azathioprine. 20 Other therapies, such as mammalian target of rapamycin (mTOR) inhibitors, are believed to have a decreased risk of skin cancer relative to calcineurin inhibitors, although risk still exists. 21 …”

Section: Discussionmentioning

confidence: 99%