Relative carcinogenicity of tacrolimus vs mycophenolate after solid organ transplantation and its implications for liver transplant care

doi:10.4254/wjh.v16.i4.650

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World Journal of Hepatology

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1948-5182

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World J Hepatol. Apr 27, 2024; 16(4): 650-660
Published online Apr 27, 2024. doi: 10.4254/wjh.v16.i4.650

Table 2 Summary of studies comparing tacrolimus to mycophenolic acid in solid organ transplantation

Ref.	Transplant era	Organ	n	De novo malignancy	Time to malignancy (median)	TAC vs no TAC (OR/HR/IRR)	MPA vs no MPA (OR/HR/IRR)
Van Leeuwen et al[50], 2009	1982 to 2003	Kidney	8162	203 lip SCC; 121 lip SCC of the lower vermillion in first transplant)	6.1 yr	SCC of the lower vermillion of lip during first transplant [IRR: 2.07, 95%CI: 0.45-9.50 (P = 0.35)]	SCC of the lower vermillion of lip during first transplant [IRR: 0.85, 95%CI: 0.28-2.60 (P = 0.77)]
Caillard et al[51], 2012	1998 to 2007	Kidney ± pancreas	21351	181 PTLD; 43 graft PTLD	Not specified	Any PTLD [aHR: 0.66, 95%CI: 0.36-1.22 (P = 0.19)]; Graft PTLD [HR: 0.33, 95%CI: 0.16-0.68 (P = 0.003)^a]	Any PTLD [aHR: 1.22, 95%CI: 0.74-2.02 (P = 0.44)]; Graft PTLD [HR: 0.44, 95%CI: 0.23-0.86 (P = 0.015)^a]
Hsiao et al[47], 2014	2000 to 2008	Kidney	642	54 non-cutaneous malignancy	3.9 yr	HR: 1.99, 95%CI: 0.66-6.00 (P = 0.22)	HR: 1.00, 95%CI: 0.40-2.45 (P = 0.99)
Coghill et al[49], 2016	1995 to 2010	Kidney ± pancreas, and heart	2004	170 SCC	9.0 yr	Single SCC (OR: 1.11, 95%CI: 0.48-2.60)	Single SCC (OR: 0.52, 95%CI: 0.32-0.84^a)
Yeh et al[46], 2020	1997 to 2011	Liver, kidney, and heart	7852	612 cutaneous and non-cutaneous malignancy	Not specified	cHR (heart): 0.6, 95%CI: 0.1-2.7; cHR (kidney): 1.5, 95%CI: 0.8-2.6; aHR (liver): 0.6, 95%CI: 0.2-1.7	cHR (heart): 1.6, 95%CI: 0.7-3.3; aHR (kidney): 1.5, 95%CI: 1.2-1.8 (P < 0.001)^a; cHR (liver): 1.5, 95%CI: 0.9-2.5
Gibson et al[48], 2021	2010 to 2018	Liver, kidney ± pancreas, heart, and lung	2852	242 cutaneous malignancy	4.7 yr	IRR: 0.83, 95%CI: 0.55-1.25 (P = 0.37)	IRR: 0.78, 95%CI: 0.54-1.12 (P = 0.18)

^aP < 0.05.

aHR: Adjusted hazard ratio; cHR: Crude hazard ratio; HR: Hazard ratio; IRR: Incidence rate ratio; MPA: Mycophenolic acid; OR: Odds ratio; PTLD: Post-transplant lymphoproliferative disorder; SCC: Squamous cell carcinoma; TAC: Tacrolimus; 95%CI: 95% confidence interval.

Citation: Liu D, Youssef MM, Grace JA, Sinclair M. Relative carcinogenicity of tacrolimus vs mycophenolate after solid organ transplantation and its implications for liver transplant care. World J Hepatol 2024; 16(4): 650-660
URL: https://www.wjgnet.com/1948-5182/full/v16/i4/650.htm
DOI: https://dx.doi.org/10.4254/wjh.v16.i4.650