Drug for fungal infections in lung transplant recipients increases risk for cancer, death

http://ekaweb02.eurekalert.org/pub_releases/2015-09/uoc--dff083115.php

Public Release: 3-Sep-2015
Drug for fungal infections in lung transplant recipients increases risk for cancer, death
UCSF researchers recommend physicians consider patient-specific factors when using voriconazole
University of California - San Francisco

Voriconazole, a prescription drug commonly used to treat fungal infections in lung transplant recipients, significantly increases the risk for skin cancer and even death, according to a new study by UC San Francisco researchers. The team recommends physicians consider patient-specific factors that could modify the drug's risks and benefits, when providing care.

Their study appears online Sept. 3, 2015, in the American Journal of Transplantation.

"It is important for physicians to be aware of the impact of voriconazole on these outcomes," said senior author Sarah Arron, MD, PhD, associate professor of dermatology and director of the UCSF High Risk Skin Cancer Clinic. "We recommend that all providers counsel lung transplant recipients on skin cancer risk and photoprotection in addition to scheduling routine skin cancer screening with a trained dermatologist after transplantation. Lung transplant programs should also consider patient-specific risk factors when deciding on the type, dose and duration of antifungal prophylaxis regimens."

Skin cancer is the most common malignancy following solid organ transplants, primarily due to immunosuppression, with recipients experiencing a greater than 65-fold increased risk of developing cutaneous squamous cell carcinoma (SCC) compared to the general population. These carcinomas are aggressive and can lead to numerous lesions, resulting in multiple debilitating surgeries and increased risk of death.

Lung transplant recipients are particularly susceptible to SCC due to older age at transplant and more intensive immunosuppression. They also have high rates of fungal infections after transplant, which can result in significant morbidity and mortality.

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