title: Recurrent non-melanoma skin cancer: remission of field cancerization after conversion from calcineurin inhibitor- to proliferation signal inhibitor-based immunosuppression in a cardiac transplant recipient.
abstract: Non-melanoma skin cancers (NMSCs) are the most common malignancies after solid organ transplantation. Their incidence increases with time after transplantation. Calcineurin-inhibitors (CNIs) and azathioprine are known as skin neoplasia-initiating and -enhancing immunosuppressants. In contrast, increasing clinical experience suggests a relevant antiproliferative effect of mammalian target of rapamycin inhibitors, also named proliferation signal inhibitors (PSIs). We report the case of a cardiac allograft recipient with an impressive and consolidated reduction of recurrent NMSC, observed after conversion from CNI-therapy to a PSI-based protocol.
authors.affiliation: Department of Cardiology, Swiss Cardiovascular Center, University Hospital Bern, Bern, Switzerland.
authors.forename: J
authors.initials: J
authors.lastname: Signorell
authors.forename: T
authors.initials: T
authors.lastname: Hunziker
authors.forename: M
authors.initials: M
authors.lastname: Martinelli
authors.forename: S C
authors.initials: SC
authors.lastname: Koestner
authors.forename: P J
authors.initials: PJ
authors.lastname: Mohacsi
mesh_terms: D065095:Calcineurin Inhibitors; D002294:Carcinoma, Squamous Cell / Q000201:enzymology / Q000209:etiology* / Q000473:pathology / Q000628:therapy; D049109:Cell Proliferation / Q000187:drug effects*; D004359:Drug Therapy, Combination; D000068338:Everolimus; D016027:Heart Transplantation / Q000009:adverse effects*; D006801:Humans; D007166:Immunosuppressive Agents / Q000009:adverse effects / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D010778:Photochemotherapy; D015398:Signal Transduction / Q000187:drug effects*; D020123:Sirolimus / Q000031:analogs & derivatives* / Q000627:therapeutic use; D012878:Skin Neoplasms / Q000201:enzymology / Q000209:etiology* / Q000473:pathology / Q000628:therapy; D058570:TOR Serine-Threonine Kinases / Q000037:antagonists & inhibitors*; D016559:Tacrolimus / Q000009:adverse effects*; D013997:Time Factors; D014184:Transplantation, Homologous; D016896:Treatment Outcome
chemical_list: D065095:Calcineurin Inhibitors; D007166:Immunosuppressive Agents; D000068338:Everolimus; C546842:MTOR protein, human; D058570:TOR Serine-Threonine Kinases; D020123:Sirolimus; D016559:Tacrolimus