title: Leflunomide with low-dose everolimus for treatment of Kaposi's sarcoma in a renal allograft recipient.
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.
authors.affiliation: Department of Nephrology, Christian Medical College, Vellore, India. drbasug@yahoo.co.in
authors.forename: Gopal
authors.initials: G
authors.lastname: Basu
authors.forename: Anjali
authors.initials: A
authors.lastname: Mohapatra
authors.forename: Marie Therese
authors.initials: MT
authors.lastname: Manipadam
authors.forename: Sunithi Elizabeth
authors.initials: SE
authors.lastname: Mani
authors.forename: George Tharayil
authors.initials: GT
authors.lastname: John
mesh_terms: D000970:Antineoplastic Agents / Q000627:therapeutic use; D000068338:Everolimus; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use*; D007555:Isoxazoles / Q000627:therapeutic use*; D007674:Kidney Diseases / Q000150:complications* / Q000628:therapy; D016030:Kidney Transplantation / Q000009:adverse effects*; D000077339:Leflunomide; D008297:Male; D008875:Middle Aged; D051057:Proto-Oncogene Proteins c-akt / Q000378:metabolism; D012514:Sarcoma, Kaposi / Q000188:drug therapy* / Q000209:etiology; D020123:Sirolimus / Q000031:analogs & derivatives* / Q000627:therapeutic use; D014184:Transplantation, Homologous; D016896:Treatment Outcome
chemical_list: D000970:Antineoplastic Agents; D007166:Immunosuppressive Agents; D007555:Isoxazoles; D000068338:Everolimus; D051057:Proto-Oncogene Proteins c-akt; D000077339:Leflunomide; D020123:Sirolimus