Cancer and transplantation intersect at the mammalian target of rapamycin.

摘要

The paper fay Gomez-Camerero et al. in this issue, "Use of everolimus as a rescue immunosuppressive therapy in liver transplantation," adds to a growing literature on mammalian target of rapamycin (mTOR) inhibitor use in cancer,. It is of interest because of the spectrum of cancers treated and because of the comparison to a similar group of cancers in liver recipients not switched. All 10 patients switched from a cakineurin inhibitor (CNI) to everolirnus (EVR) had remissions. Despite three deaths (two not from cancer), the average survival exceeded 20 months compared to 5.3 months in controls. Both groups had conventional treatments (surgery, radiation, and chemotherapy). Rapamycins are as immunosuppressive as CNIs, yet they reduce the risk of cancer in transplant recipients compared to CNIs (I) and they appear useful for treating new cancers. Unraveling the actions of rapamycin has increased our understanding of growth pathways of normal and cancer cells.