title: Daunting but Worthy Goal: Reducing the De Novo Cancer Incidence After Transplantation.
abstract: Solid-organ transplant recipients are at increased risk of developing de novo malignancies compared with the general population, and malignancies become a major limitation in achieving optimal outcomes. The prevention and the management of posttransplant malignancies must be considered as a main goal in our transplant programs. For these patients, immunosuppression plays a major role in oncogenesis by both impairement of immunosurveillance, enhancement of chronic viral infection, and by direct prooncogenic effects. It is essential to manage the recipient with a long-term adapted screening program beginning before transplantation to use a prophylaxis to decrease infection-related cancer, to propose a viral monitoring, and to modulate the immunosuppression toward lower doses especially for calcineurin inhibitors. Indeed, strategies to induce tolerance or to allow a dramatic reduction of the immunosuppression burden are the more promising approaches for the reduction of the posttransplant malignancies.
authors.affiliation: 1 Institut de Transplantation-Urologie-Néphrologie (ITUN), CHU Nantes, Nantes, France. 2 Institut de Cancérologie de l'Ouest (ICO), Nantes, France.
authors.forename: Jacques
authors.initials: J
authors.lastname: Dantal
authors.forename: Mario
authors.initials: M
authors.lastname: Campone
mesh_terms: D000818:Animals; D065095:Calcineurin Inhibitors / Q000627:therapeutic use; D063646:Carcinogenesis; D006085:Graft Survival; D006801:Humans; D007165:Immunosuppression Therapy; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D015994:Incidence; D007676:Kidney Failure, Chronic / Q000276:immunology / Q000601:surgery*; D007680:Kidney Neoplasms / Q000276:immunology / Q000601:surgery*; D008403:Mass Screening / Q000379:methods; D051379:Mice; D015166:Monitoring, Immunologic / Q000379:methods*; D009369:Neoplasms / Q000453:epidemiology* / Q000209:etiology*; D011183:Postoperative Complications; D011379:Prognosis; D012307:Risk Factors; D014180:Transplantation / Q000009:adverse effects*; D023001:Transplantation Tolerance
chemical_list: D065095:Calcineurin Inhibitors; D007166:Immunosuppressive Agents