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Sirolimus may not reduce SCC risk in solid organ transplant recipients

Sirolimus exposure in solid organ transplant recipients was not significantly associated with a reduction in the risk of posttransplantation squamous cell carcinoma, according to recently published study results.

Maryam M. Asgari, MD, MPH, and colleagues studied incident squamous cell carcinoma (SCC) and its relationship to sirolimus in a retrospective cohort of all Kaiser Permanente Northern California members who were solid organ transplant recipients between 2000 and 2010. Electronic pharmacy records were used to determine sirolimus use, and health plan electronic pathology records used to identify posttransplantation SCCs.

Maryam M. Asgari

Among 3,539 transplant recipients (mean age, 52.1 years; 60.3% men), 488 patients were exposed to sirolimus. A total of 251 patients were diagnosed with incident SCC, with 81.7% occurring in the first 5 years of follow-up. Forty-seven of the patients diagnosed with incident SCC were exposed to sirolimus.

Ever use of sirolimus did not have an association with SCC risk (adjusted hazard ratio = 1.18; 95% CI, 0.84-1.16). Cumulative duration of sirolimus exposure (adjusted HR = 2.75; 95% CI, 0.84-9.04) also was not associated SCC risk when long-term users were compared with nonusers.

 “Given the ubiquitous and growing use of sirolimus therapy among [transplant recipients] and the public health relevance of SCCs in the transplantation population, additional studies are needed to clarify the role of sirolimus in primary prevention of SCCs in [transplant recipients],” the researchers concluded. – By Bruce Thiel

Disclosure: Asgari reports receiving grant funding to Kaiser Permanente from Pfizer and Valeant Pharmaceuticals. The other researchers report no relevant disclosures.