Affordable Access

deepdyve-link
Publisher Website

Temsirolimus as Base Immunosuppressant for a Recipient With Metastatic Renal Cancer: Adequate Immunosuppression and Oncological Control—Case Report

Authors
  • Chueh, S.J.
  • Sankari, B.R.
  • Gonzales-Chambers, R.
  • Lipscomb, L.
  • Africa, J.
  • Williams, J.
  • Jones, A.M.1, 2, 3, 4, 5, 6, 7
  • 1 Glickman Urological and Kidney Institute
  • 2 Cleveland Clinic
  • 3 Cleveland Clinic Lerner College of Medicine
  • 4 Case Western Reserve University
  • 5 Kidney Transplant Program
  • 6 Charleston Area Medical Center
  • 7 Princeton Hematology Oncology
Type
Published Article
Journal
Transplantation Proceedings
Publisher
Elsevier
Publication Date
Jan 01, 2014
Volume
46
Issue
1
Pages
271–273
Identifiers
DOI: 10.1016/j.transproceed.2013.08.106
Source
Elsevier
License
Unknown

Abstract

Treating organ recipients who have metastatic renal cell carcinoma (mRCC) is challenging because of the dilemma between transplant-required immunosuppression and cancer control via boosting immunity with immunotherapy. We report such a patient whose case was successfully maintained only with temsirolimus and low-dose steroids, while achieving good allograft function and oncological outcomes. After removal of his primary renal cancer, a kidney recipient was found to have multiple metastases. Since recovery from surgery he has been administered 25 mg/wk temsirolimus for 2 more years. His mRCC is in partial remission, the serum creatinine level has been stable (∼ 1.6 mg/dL), and the performance score has been good. Adverse effects encountered include transient transaminitis, dyslipidemia, and poorly controlled hyperglycemia. The pharmacokinetics of sirolimus (the major first metabolite of temsirolimus) is depicted to speculate the underlying mechanism. To our knowledge, this is the first sustainable success using temsirolimus-based immunotherapy (both immunosuppression and cancer therapy) in a transplant recipient who has mRCC.

Report this publication

Statistics

Seen <100 times