Cancer risk the same for kidney transplant recipients, no matter the drug

Apr 29, 2010

Drugs taken by kidney transplant recipients to prevent organ rejection carry similar risks of cancer, according to a study appearing in an upcoming issue of the Journal of the American Society Nephrology (JASN). The results suggest that no single medication is to blame for the higher incidence of cancer seen among patients who have undergone transplantation.

Individuals who receive a have an increased risk of developing cancer compared with the general population. Researchers suspected that the increased risk may come from immunosuppressive medications that patients must take long-term to prevent . To investigate, Martin Gallagher, MBBS, FRACP (The George Institute for International Health in Australia) and his colleagues studied the incidence of cancer in who took part in a randomized clinical trial 20 years ago, looking for any differences in cancer risk associated with different immunosuppressive drugs.

The researchers studied the incidence of cancer among 481 kidney transplant recipients in the Australian Multicentre Trial of Withdrawal who each received one of three treatment regimens: azathioprine and prednisolone, cyclosporine monotherapy, or cyclosporine monotherapy followed by a switch to azathioprine and prednisolone after three months.

A total of 226 patients in the trial developed at least one cancer. By 20 years post transplant, 27% of patients developed non-skin cancer and 48% of patients developed . One type of treatment did not have a greater effect on cancer timing or incidence than another, indicating that the therapies carry similar risks for cancer after kidney transplantation.

"We have shown no significant differences with a high degree of precision, allowing us to conclude that any differences in cancer risk from these different treatments are unlikely to be clinically significant," said Dr. Gallagher. He added that this study provides the strongest evidence yet that no single immunosuppressive medication appears to drive the increase in cancer risk seen after transplantation.

The study also indicates that certain patient characteristics that are known at the time of transplantation have a significant effect on recipients' increased risk of cancer. (Non-skin cancer was associated with increasing age and previous smoking history; skin cancer was associated with increasing age, non-brown eye color, fairer skin, and a functioning transplant.) Therefore, patients at especially high risk can be monitored more closely and use preventive measures to protect against cancer.

The authors noted that immune suppressive treatments have evolved since the trial was designed 20 years ago. It is likely that today's immunosuppressive regimens, which are better at preventing acute rejection, are more potent at immunosuppression.

Explore further: Team identifies source of most cases of invasive bladder cancer

More information: The article, entitled "Long-Term Cancer Risk of Immunosuppressive Regimens after Kidney Transplantation," will appear online on April 29, 2010, doi:10.1681/ASN.2009101043

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akotlar
not rated yet Apr 29, 2010
I love non-functional discoveries. Ok, so it's well known that the immune system plays a major role in cancer suppression. Great, too bad that there's nothing we can do about it. Personally I'd rather not know.

"Therefore patients...can be monitored more closely and use preventative measures to protect against cancer."

Oh yeah? Like what? If I walked into an oncologist's office today, and asked him what I could do to lower my risk factor for cancer, he'd tell me to move somewhere without cars, eat well, don't drink BPA, don't smoke, don't drink. That's it. That's the same thing you'd tell anyone.

That's roughly the sum of our FDA sanctioned prophylactic cancer course.

One thing to note, is that the population wide cancer risk in the U.S is about .5 regardless, so this study doesn't look like it says anything about overall risk of getting some type of cancer.

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