Impact of mTOR Inhibitors on Cancer Development in Kidney Transplantation Recipients: A Population-Based Study

C. C. Kao, J. S. Liu, M. H. Lin, C. Y. Hsu, F. C. Chang, Y. C. Lin, H. H. Chen, T. W. Chen, C. C. Hsu, M. S. Wu

Research output: Contribution to journalArticle

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Abstract

Background The mammalian target of rapamycin (mTOR) inhibitor is an immunosuppressive drug used in kidney transplantation. Whether the mTOR inhibitor is associated with reduced risk of cancer development and mortality after kidney transplantation is controversial. Methods We conducted a nationwide population-based study. Patients who did not have malignancy history and received kidney transplantation between 2010 and 2013 were enrolled. Recipients who had mTOR inhibitors (n = 430) for more than 30 days comprised the study group; 1720 recipients who did not have mTOR inhibitors comprised the control group. The primary outcome is the development of cancer after kidney transplantation. These patients were followed until the first-time admission with diagnosis of cancer, death, or the end of 2014. A Cox proportional-hazard model was used to determine the risk of cancer development and all-cause mortality. Results During the 35-month median duration of observation, there were 16 and 61 patients with cancer development in the study group and the control group, respectively. The cancer incidence was 12.8 and 12.4 per 1000 person-years. There were 10 and 135 mortality cases, with the incidence rate of 7.8 and 26.9 per 1000 person-years. After multivariable adjustment, the mTOR inhibitors users were not associated with reduced risk of new cancer development as compared with control (hazard ratio [HR], 0.86; 95% confidence interval [CI], 0.46-1.60; P =.63), nor risk of all-cause mortality (HR, 0.70; 95% CI, 0.33-1.46; P =.34). Conclusions The use of mTOR inhibitors was not associated with a reduction in the risk of cancer development and all-cause mortality in kidney transplantation recipients.

Original languageEnglish
Pages (from-to)900-904
Number of pages5
JournalTransplantation Proceedings
Volume48
Issue number3
DOIs
Publication statusPublished - Apr 1 2016

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Sirolimus
Kidney Transplantation
Population
Neoplasms
Mortality
Confidence Intervals
Safety Management
Social Adjustment
Control Groups
Kidney Neoplasms
Incidence
Risk Reduction Behavior
Immunosuppressive Agents
Proportional Hazards Models
Observation
Pharmaceutical Preparations

ASJC Scopus subject areas

  • Surgery
  • Transplantation

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Impact of mTOR Inhibitors on Cancer Development in Kidney Transplantation Recipients : A Population-Based Study. / Kao, C. C.; Liu, J. S.; Lin, M. H.; Hsu, C. Y.; Chang, F. C.; Lin, Y. C.; Chen, H. H.; Chen, T. W.; Hsu, C. C.; Wu, M. S.

In: Transplantation Proceedings, Vol. 48, No. 3, 01.04.2016, p. 900-904.

Research output: Contribution to journalArticle

Kao, C. C. ; Liu, J. S. ; Lin, M. H. ; Hsu, C. Y. ; Chang, F. C. ; Lin, Y. C. ; Chen, H. H. ; Chen, T. W. ; Hsu, C. C. ; Wu, M. S. / Impact of mTOR Inhibitors on Cancer Development in Kidney Transplantation Recipients : A Population-Based Study. In: Transplantation Proceedings. 2016 ; Vol. 48, No. 3. pp. 900-904.
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abstract = "Background The mammalian target of rapamycin (mTOR) inhibitor is an immunosuppressive drug used in kidney transplantation. Whether the mTOR inhibitor is associated with reduced risk of cancer development and mortality after kidney transplantation is controversial. Methods We conducted a nationwide population-based study. Patients who did not have malignancy history and received kidney transplantation between 2010 and 2013 were enrolled. Recipients who had mTOR inhibitors (n = 430) for more than 30 days comprised the study group; 1720 recipients who did not have mTOR inhibitors comprised the control group. The primary outcome is the development of cancer after kidney transplantation. These patients were followed until the first-time admission with diagnosis of cancer, death, or the end of 2014. A Cox proportional-hazard model was used to determine the risk of cancer development and all-cause mortality. Results During the 35-month median duration of observation, there were 16 and 61 patients with cancer development in the study group and the control group, respectively. The cancer incidence was 12.8 and 12.4 per 1000 person-years. There were 10 and 135 mortality cases, with the incidence rate of 7.8 and 26.9 per 1000 person-years. After multivariable adjustment, the mTOR inhibitors users were not associated with reduced risk of new cancer development as compared with control (hazard ratio [HR], 0.86; 95{\%} confidence interval [CI], 0.46-1.60; P =.63), nor risk of all-cause mortality (HR, 0.70; 95{\%} CI, 0.33-1.46; P =.34). Conclusions The use of mTOR inhibitors was not associated with a reduction in the risk of cancer development and all-cause mortality in kidney transplantation recipients.",
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T1 - Impact of mTOR Inhibitors on Cancer Development in Kidney Transplantation Recipients

T2 - A Population-Based Study

AU - Kao, C. C.

AU - Liu, J. S.

AU - Lin, M. H.

AU - Hsu, C. Y.

AU - Chang, F. C.

AU - Lin, Y. C.

AU - Chen, H. H.

AU - Chen, T. W.

AU - Hsu, C. C.

AU - Wu, M. S.

PY - 2016/4/1

Y1 - 2016/4/1

N2 - Background The mammalian target of rapamycin (mTOR) inhibitor is an immunosuppressive drug used in kidney transplantation. Whether the mTOR inhibitor is associated with reduced risk of cancer development and mortality after kidney transplantation is controversial. Methods We conducted a nationwide population-based study. Patients who did not have malignancy history and received kidney transplantation between 2010 and 2013 were enrolled. Recipients who had mTOR inhibitors (n = 430) for more than 30 days comprised the study group; 1720 recipients who did not have mTOR inhibitors comprised the control group. The primary outcome is the development of cancer after kidney transplantation. These patients were followed until the first-time admission with diagnosis of cancer, death, or the end of 2014. A Cox proportional-hazard model was used to determine the risk of cancer development and all-cause mortality. Results During the 35-month median duration of observation, there were 16 and 61 patients with cancer development in the study group and the control group, respectively. The cancer incidence was 12.8 and 12.4 per 1000 person-years. There were 10 and 135 mortality cases, with the incidence rate of 7.8 and 26.9 per 1000 person-years. After multivariable adjustment, the mTOR inhibitors users were not associated with reduced risk of new cancer development as compared with control (hazard ratio [HR], 0.86; 95% confidence interval [CI], 0.46-1.60; P =.63), nor risk of all-cause mortality (HR, 0.70; 95% CI, 0.33-1.46; P =.34). Conclusions The use of mTOR inhibitors was not associated with a reduction in the risk of cancer development and all-cause mortality in kidney transplantation recipients.

AB - Background The mammalian target of rapamycin (mTOR) inhibitor is an immunosuppressive drug used in kidney transplantation. Whether the mTOR inhibitor is associated with reduced risk of cancer development and mortality after kidney transplantation is controversial. Methods We conducted a nationwide population-based study. Patients who did not have malignancy history and received kidney transplantation between 2010 and 2013 were enrolled. Recipients who had mTOR inhibitors (n = 430) for more than 30 days comprised the study group; 1720 recipients who did not have mTOR inhibitors comprised the control group. The primary outcome is the development of cancer after kidney transplantation. These patients were followed until the first-time admission with diagnosis of cancer, death, or the end of 2014. A Cox proportional-hazard model was used to determine the risk of cancer development and all-cause mortality. Results During the 35-month median duration of observation, there were 16 and 61 patients with cancer development in the study group and the control group, respectively. The cancer incidence was 12.8 and 12.4 per 1000 person-years. There were 10 and 135 mortality cases, with the incidence rate of 7.8 and 26.9 per 1000 person-years. After multivariable adjustment, the mTOR inhibitors users were not associated with reduced risk of new cancer development as compared with control (hazard ratio [HR], 0.86; 95% confidence interval [CI], 0.46-1.60; P =.63), nor risk of all-cause mortality (HR, 0.70; 95% CI, 0.33-1.46; P =.34). Conclusions The use of mTOR inhibitors was not associated with a reduction in the risk of cancer development and all-cause mortality in kidney transplantation recipients.

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DO - 10.1016/j.transproceed.2016.01.017

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VL - 48

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SN - 0041-1345

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