Results of the Conversion to Everolimus in Renal Transplant Recipients With Posttransplantation Malignancies

Everolimus and Malignancy after Solid Organ Transplantation: A Clinical Update

“…Identifying the contribution for everolimus is inevitably difficult since other interventions are also usually instituted, reflecting real-life practice. A cohort of 21 patients with malignant neoplasms who were converted to everolimus at a mean of 108 months after kidney transplantation was documented in the Argentinean Registry of Renal Transplant Recipients [47]. The malignancies included skin (7), gynecological (3), gastrointestinal (3), renal (2), prostate (1), central nervous system (1) cancers, posttransplant lymphoproliferative disease (PTLD, 2), seminoma (1), and Kaposi's sarcoma (1).…”

Conversion to everolimus in maintenance liver transplant patients: A multicenter, retrospective analysis

“…Single-arm studies have demonstrated that maintenance liver transplant patients can be converted from CNIs to everolimus safely at later time points with a low rate of acute rejection. [17][18][19][20][21][22] Like kidney transplant recipients, 23 liver transplant recipients with kidney dysfunction apparently need to be switched from CNI immunosuppression to everolimus either early after transplantation 16 or before the establishment of severe dysfunction. 17 In clinical practice, some centers now initiate everolimus in maintenance liver transplant patients who develop kidney dysfunction or, less frequently, posttransplant neoplasms and attempt to withdraw CNI therapy.…”

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

“…The literature includes a number of single-center reports from small series of maintenance kidney transplant patients who were switched from CNI therapy to everolimus in response to declining renal function [45,46], malignant neoplasms or nonmelanoma skin cancer [47][48][49][50] or, more frequently, a mixture of indications but primarily renal deterioration or malignancy [51][52][53][54]. Studies of cohorts switched due to renal causes or for mixed reasons have consistently shown a significant improvement in renal function over follow-up periods ranging from six months to two years [45,46,[51][52][53][54].…”

“…Published cases of conversion from CNI therapy to everolimus in response to malignancy describe a variety of tumor types with varying surgical and adjunctive interventions, and have generally concluded that conversion is a valid therapeutic approach which helps to control disease progression [47][48][49][50].…”