title: The role of new immunosuppressive drugs in nonmelanoma skin cancer in renal transplant recipients.
abstract: BACKGROUND
  Nonmelanoma skin cancer (NMSC) is the most common malignancy in patients who have received a solid organ transplant. Multiple factors are involved in the onset of posttransplant NMSC.
  
  
  OBJECTIVE
  To analyze the relationship between new immunosuppressive drugs and the onset of NMSC in renal transplant recipients.
  
  
  METHODS
  This was a combined retrospective and prospective observational study in which we studied 289 patients who received a kidney transplant between January 1996 and December 2010 at Hospital Universitario Doctor Peset in Valencia, Spain.
  
  
  RESULTS
  Seventy-three patients (25.2%) developed 162 NMSCs over a median follow-up of 72 months. There were no statistically significant differences in the onset of NMSC on comparing different induction therapy strategies involving monoclonal and polyclonal antibodies. NMSCs occurred less frequently in patients treated with mammalian target of rapamycin (mTOR) inhibitors than in those treated with other immunosuppressive regimens, although the differences were not statistically significant. Three of 5 patients with recurrent NMSC who were switched from calcineurin inhibitors to mTOR inhibitors developed additional NMSCs despite the change.
  
  
  CONCLUSIONS
  Induction therapy with monoclonal and polyclonal antibodies in renal transplant recipients is not associated with an increased risk of NMSC. While mTOR inhibitors are associated with a lower risk of posttransplant NMSC, it remains to be determined whether a switch to these drugs is useful in the management of patients who develop multiple NMSCs.
authors: Servicio Dermatología, Hospital Universitario Doctor Peset, Valencia, España. Electronic address: josefabernat@hotmail.com.
authors: J
authors: J
authors: Bernat-García
authors: Unidad de Salud Pública, Higiene y Sanidad Ambiental, Departamento de Medicina Preventiva y Salud Pública, Universitat de València, CIBERESP: CIBER Epidemiología y Salud Pública, Valencia, España.
authors: M
authors: M
authors: Morales Suárez-Varela
authors: Servicio Dermatología, Hospital General Universitario de Valencia, Valencia, España.
authors: J J
authors: JJ
authors: Vilata-Corell
authors: Servicio Dermatología, Hospital Universitario Doctor Peset, Valencia, España.
authors: A
authors: A
authors: Marquina-Vila
authors: Servicio de Nefrología, Hospital Universitario Doctor Peset, Valencia, Valencia, España.
authors: L
authors: L
authors: Pallardo
authors: Servicio de Nefrología, Hospital Universitario Doctor Peset, Valencia, Valencia, España.
authors: J
authors: J
authors: Crespo
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D006801:Humans; D007166:Immunosuppressive Agents / Q000009:adverse effects*; D016030:Kidney Transplantation; D008875:Middle Aged; D011446:Prospective Studies; D012189:Retrospective Studies; D012878:Skin Neoplasms / Q000139:chemically induced* / Q000453:epidemiology*; D055815:Young Adult
chemical_list: D007166:Immunosuppressive Agents
keywords: Cáncer cutáneo; Immunosuppression; Inhibidores mTOR; Inmunosupresión; Renal transplant; Skin cancer; Trasplante renal; mTOR inhibitors