1. Leflunomide with low-dose everolimus for treatment of Kaposi's sarcoma in a renal allograft recipient
- Author
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Anjali Mohapatra, Marie Therese Manipadam, Sunithi Mani, George John, and Gopal Basu
- Subjects
Male ,medicine.medical_treatment ,Antineoplastic Agents ,medicine ,Humans ,Transplantation, Homologous ,Everolimus ,Sarcoma, Kaposi ,Kaposi's sarcoma ,PI3K/AKT/mTOR pathway ,Leflunomide ,Sirolimus ,Transplantation ,Kidney ,business.industry ,virus diseases ,Immunosuppression ,Isoxazoles ,Middle Aged ,medicine.disease ,Kidney Transplantation ,Treatment Outcome ,medicine.anatomical_structure ,Nephrology ,Immunology ,Cancer research ,Kidney Diseases ,Sarcoma ,business ,Proto-Oncogene Proteins c-akt ,Immunosuppressive Agents ,medicine.drug - Abstract
Current treatment of Kaposi's sarcoma is reduction of immunosuppression with or without addition of mammalian target of rapamycin inhibitors (mTORi). Akt signalling plays a central role in oncogenesis of Kaposi's sarcoma. We describe a case of multifocal Kaposi's sarcoma in a renal allograft recipient, which showed unsatisfactory early response to immunosuppression reduction along with everolimus therapy but completely resolved after adding leflunomide. mTORi impair Kaposi's sarcoma oncogenesis by inhibiting mTOR downstream from the Akt signalling. Leflunomide inhibits Akt phosphorylation. This synergistic effect may be beneficial in treatment of Kaposi sarcoma and needs to be explored in trials.
- Published
- 2011
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