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Antifungal Treatment Voriconazole Linked to Cancer Risk

Treatment may cause skin cancer in lung transplant recipients

Voriconazole, used to treat fungal infections in lung transplant recipients, has been reported to increase their risk of skin cancer and mortality, according to a report posted on the MD Magazine website.

Because transplant recipients require more-intensive immunosuppression therapy, they are 65 times more likely to develop cutaneous squamous-cell carcinoma (SCC) than the general population. Transplant recipients are also more susceptible to fungal infections caused by Aspergillus fungi, which could potentially lead to aspergillosis.

In the study published in the American Journal of Transplantation, researchers examined 455 single-lung, double-lung, and heart-lung transplant recipients at the University of California, San Francisco (UCSF), between October 1991 and December 2012. The team identified which patients had been exposed to voriconazole and assessed how the drug affected SCC, Aspergillus colonization, aspergillosis, and all-cause mortality.

The study results indicated that risk for SCC significantly increased by 73% when patients were exposed to voriconazole (the risk increase directly paralleled the length of drug exposure). 

The drug exposure did not reduce the risk of aspergillosis, but it did reduce all-cause mortality.

 “It is important for physicians to be aware of the impact of voriconazole on these outcomes,” said Sarah Arron, MD, director of the UCSF High-Risk Skin Cancer Clinic.

“Lung transplant programs should also consider patient-specific risk factors when deciding on the type, dose, and duration of antifungal prophylaxis regimens,” she added.

Source: MD Magazine; September 3, 2015

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