1. Management of Kaposi sarcoma after solid organ transplantation: A European retrospective study
- Author
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Delyon, J., Rabate, C., Euvrard, S., Harwood, C.A., Proby, C., Gulec, T., Seckin, D., Marmol, V. del, Bouwes Bavinck, J.N., Ferrandiz-Pulido, C., Ocampo, M.A., Barete, S., Legendre, C., Frances, C., Porcher, R., Lebbe, C., Skin Care Organ Transplant Patient, Immunologie humaine, physiopathologie & immunothérapie (HIPI (UMR_S_976 / U976)), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Paris (UP), Service Néphrologie et transplantation rénale Adultes [CHU Necker], CHU Necker - Enfants Malades [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Service de Dermatologie [CHU Pitié-Salpêtrière], CHU Pitié-Salpêtrière [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Service de dermatologie et allergologie [CHU Tenon], CHU Tenon [AP-HP], Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Centre de Recherche Épidémiologie et Statistique Sorbonne Paris Cité (CRESS (U1153 / UMR_A_1125 / UMR_S_1153)), and Conservatoire National des Arts et Métiers [CNAM] (CNAM)-Université Sorbonne Paris Cité (USPC)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Paris (UP)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE)
- Subjects
Oncology ,Adult ,Male ,medicine.medical_specialty ,Skin Neoplasms ,mTOR inhibitor ,medicine.medical_treatment ,[SDV]Life Sciences [q-bio] ,Antineoplastic Agents ,Dermatology ,chemotherapy ,Organ transplantation ,Tacrolimus ,030207 dermatology & venereal diseases ,03 medical and health sciences ,0302 clinical medicine ,Internal medicine ,Antineoplastic Combined Chemotherapy Protocols ,medicine ,Humans ,Progression-free survival ,Sarcoma, Kaposi ,Retrospective Studies ,Sirolimus ,Chemotherapy ,immunosuppression ,business.industry ,Drug Substitution ,TOR Serine-Threonine Kinases ,Hazard ratio ,Graft Survival ,Kaposi sarcoma ,Retrospective cohort study ,Immunosuppression ,Organ Transplantation ,Middle Aged ,medicine.disease ,3. Good health ,Calcineurin ,Europe ,Survival Rate ,030220 oncology & carcinogenesis ,Female ,Sarcoma ,business ,post-transplant malignancies ,Immunosuppressive Agents - Abstract
Background Systemic therapeutic management of post-transplant Kaposi sarcoma (KS) is mainly based on 3 axes: reduction of immunosuppression, conversion to mammalian target of rapamycin (mTOR) inhibitors, chemotherapy, or a combination of these. Objective To obtain an overview of clinical strategies about the current treatment of KS. Methods We conducted a multicenter retrospective cohort study including 145 solid organ transplant recipients diagnosed with KS between 1985 and 2011 to collect data regarding first-line treatment and response at 6 months. Results Overall, 95%, 28%, and 16% of patients had reduction of immunosuppression, conversion to mTOR inhibitor, and chemotherapy, respectively. Patients treated with chemotherapy or mTOR inhibitor conversion were more likely to have visceral KS. At 6 months, 83% of patients had response, including 40% complete responses. Limitations The retrospective design of the study. Conclusion Currently available therapeutic options seem to be effective to control KS in most patients. Tapering down the immunosuppressive regimen remains the cornerstone of KS management.
- Published
- 2019
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