Renal Transplantation Clinical Trial
Official title:
Study of the Impact of VEGF Polymorphism on the Development of Renal Carcinoma in Renal Transplant Patients
Renal transplant patients have on average 3-5 times more risk of developing cancer than the
general population. This rate can be increased up to 10 to 15 times in some type of cancer
like kidney cancer. Among the identified risk factors, immunosuppressants and, in
particular, calcineurin inhibitors (ciclosporin and tacrolimus) play a major role in
increasing cancers apart from their depressant effects on the immune system.
Calcineurin inhibitors (CCN) are the basis of immunosuppressive therapy in renal
transplantation. Several mechanisms have been implicated to explain their pro-oncogenic
properties. One related to an increase in VEGF expression seems particularly interesting in
the study of renal cell carcinoma in the transplanted patient. Indeed, the physiopathology
of kidney cancer has clearly been associated with an increase in the production of VEGF.
Furthermore, some polymorphisms of the gene encoding VEGF have already been associated with
the survival of patients with renal carcinoma and the circulating level of VEGF in the
general population. The search for an association between the polymorphisms of the VEGF gene
and renal carcinoma in renal transplant patients could thus identify patients whose risk of
renal cell carcinoma (cRCC) post-transplantation is increased. If the involvement of certain
polymorphisms in the development of cRCC was confirmed in this population, their research
before the introduction of the immunosuppressive treatment would make it possible to direct
the choice of treatment towards molecules without pro-oncogenic property in the Patients
such as mTOR protein inhibitors (sirolimus, everolimus). This research project is therefore
in line with the desire to move towards a more "personalized" medicine that could be
beneficial for the patient.
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