{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T17:03:39Z","timestamp":1782925419875,"version":"3.54.5"},"reference-count":28,"publisher":"Oxford University Press (OUP)","issue":"9","license":[{"start":{"date-parts":[[2020,12,14]],"date-time":"2020-12-14T00:00:00Z","timestamp":1607904000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"name":"Pfizer Pharma"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2021,8,30]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Renal transplant recipients have an increased cancer risk. The mammalian target of rapamycin inhibitor sirolimus (SRL) has immunosuppressive and antitumour activities but knowledge about its use in recipients with cancer is limited.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>We retrospectively analysed 726 renal allograft recipients converted to SRL from 10 German transplant centres. Patient and graft survival were analysed depending on malignancy status prior to conversion and tumour entity.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Malignancy before conversion to SRL was reported in 230 patients, with 137 patients having skin cancers and 101 having solid cancers. Cancer occurred 4.6\u2009\u00b1\u20099.4 (median 3.0) years after transplantation. Basal cell carcinoma, squamous cell carcinoma and Bowen\u2019s disease were the most prevalent skin cancers, while carcinomas of the kidney, colon and breast were the most prevalent solid cancers before conversion. Patients with prior malignancy were older and had better renal function at conversion compared with patients without a history of cancer. After conversion to SRL, cancer incidence rates (IRs) of all tumours were lower compared with rates before conversion. Cancer IRs after conversion were higher in patients with malignancy before conversion compared with those without. Patient survival was worse in patients with solid cancers compared with patients with skin cancers or without malignancies. Biopsy-proven acute rejections in the first year after conversion were less frequent in patients with malignancy compared with those without. Graft survival and renal function in all cancer types were better than in patients converted to SRL without cancers.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>Conversion to SRL in patients with a history of cancer is safe regarding renal function and graft survival, while patient survival is largely dependent on tumour entity.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ckj\/sfaa262","type":"journal-article","created":{"date-parts":[[2020,12,10]],"date-time":"2020-12-10T18:53:23Z","timestamp":1607626403000},"page":"2047-2058","source":"Crossref","is-referenced-by-count":9,"title":["Sirolimus in renal transplant recipients with malignancies in Germany"],"prefix":"10.1093","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6063-2806","authenticated-orcid":false,"given":"Marcel G","family":"Naik","sequence":"first","affiliation":[{"name":"Division of Nephrology, Charit\u00e9 University-Mitte, Berlin, Germany"},{"name":"Berliner Institut f\u00fcr Gesundheitsforschung\/Berlin Institute of Health (BIH) K\u00f6rperschaft des \u00f6ffentlichen Rechts Anna-Louisa-Karsch-Str. 2 10178 Berlinn, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wolfgang","family":"Arns","sequence":"additional","affiliation":[{"name":"Transplant Centre Cologne, Cologne General Hospital, Cologne, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Klemens","family":"Budde","sequence":"additional","affiliation":[{"name":"Division of Nephrology, Charit\u00e9 University-Mitte, Berlin, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fritz","family":"Diekmann","sequence":"additional","affiliation":[{"name":"Department of Nephrology and Kidney Transplantation, Hospital Clinic, Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Frank","family":"Eitner","sequence":"additional","affiliation":[{"name":"Division of Nephrology and Immunology, Kidney Diseases Research, RWTH Aachen University Hospital, Bayer AG, Wuppertal, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wilfried","family":"Gwinner","sequence":"additional","affiliation":[{"name":"Division of Nephrology, Hannover Medical School, Hannover, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nils","family":"Heyne","sequence":"additional","affiliation":[{"name":"Division of Nephrology, University of T\u00fcbingen, T\u00fcbingen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jan Steffen","family":"J\u00fcrgensen","sequence":"additional","affiliation":[{"name":"Division of Nephrology, Charit\u00e9 University - Virchow, Berlin, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christian","family":"Morath","sequence":"additional","affiliation":[{"name":"Division of Nephrology, University of Heidelberg, Heidelberg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Udo","family":"Riester","sequence":"additional","affiliation":[{"name":"Pfizer Pharma GmbH, Berlin, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katharina M","family":"Heller","sequence":"additional","affiliation":[{"name":"Department of Medicine, Division of Nephrology, University of Erlangen, Erlangen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Fischereder","sequence":"additional","affiliation":[{"name":"Department of Medicine IV, University Hospital of Munich, Munich, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2020,12,14]]},"reference":[{"key":"2021083109014443300_sfaa262-B1","doi-asserted-by":"crossref","first-page":"1091","DOI":"10.1002\/ijc.30531","article-title":"Cancer risks after solid organ transplantation and after long-term dialysis","volume":"140","author":"Hortlund","year":"2017","journal-title":"Int J Cancer"},{"key":"2021083109014443300_sfaa262-B2","doi-asserted-by":"crossref","first-page":"1891","DOI":"10.1001\/jama.2011.1592","article-title":"Spectrum of cancer risk among US solid organ transplant recipients","volume":"306","author":"Engels","year":"2011","journal-title":"JAMA"},{"key":"2021083109014443300_sfaa262-B3","doi-asserted-by":"crossref","first-page":"858","DOI":"10.1097\/TP.0000000000001385","article-title":"Clinical and economic consequences of early cancer after kidney transplantation in contemporary practice","volume":"101","author":"Dharnidharka","year":"2017","journal-title":"Transplantation"},{"key":"2021083109014443300_sfaa262-B4","doi-asserted-by":"crossref","first-page":"1777","DOI":"10.1097\/01.TP.0000120181.89206.54","article-title":"Pro- and anti-cancer effects of immunosuppressive agents used in organ transplantation","volume":"77","author":"Guba","year":"2004","journal-title":"Transplantation"},{"key":"2021083109014443300_sfaa262-B5","doi-asserted-by":"crossref","first-page":"128","DOI":"10.1038\/nm0202-128","article-title":"Rapamycin inhibits primary and metastatic tumor growth by antiangiogenesis: involvement of vascular endothelial growth factor","volume":"8","author":"Guba","year":"2002","journal-title":"Nat Med"},{"key":"2021083109014443300_sfaa262-B6","doi-asserted-by":"crossref","first-page":"1146","DOI":"10.1111\/j.1600-6143.2012.04004.x","article-title":"Randomized controlled trial of sirolimus for renal transplant recipients at high risk for nonmelanoma skin cancer","volume":"12","author":"Campbell","year":"2012","journal-title":"Am J Transplant"},{"key":"2021083109014443300_sfaa262-B7","doi-asserted-by":"crossref","first-page":"329","DOI":"10.1056\/NEJMoa1204166","article-title":"Sirolimus and secondary skin-cancer prevention in kidney transplantation","volume":"367","author":"Euvrard","year":"2012","journal-title":"N Engl J Med"},{"key":"2021083109014443300_sfaa262-B8","doi-asserted-by":"crossref","first-page":"303","DOI":"10.1097\/TP.0b013e3182247ae2","article-title":"Lower malignancy rates in renal allograft recipients converted to sirolimus-based, calcineurin inhibitor-free immunotherapy: 24-month results from the CONVERT trial","volume":"92","author":"Alberu","year":"2011","journal-title":"Transplantation"},{"key":"2021083109014443300_sfaa262-B9","doi-asserted-by":"crossref","first-page":"67","DOI":"10.1111\/ctr.12280","article-title":"Proteinuria and sirolimus after renal transplantation: a retrospective analysis from a large German multicenter database","volume":"28","author":"Naik","year":"2014","journal-title":"Clin Transplant"},{"key":"2021083109014443300_sfaa262-B10","doi-asserted-by":"crossref","first-page":"461","DOI":"10.7326\/0003-4819-130-6-199903160-00002","article-title":"A more accurate method to estimate glomerular filtration rate from serum creatinine: a new prediction equation. 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