Management of metastatic castrate-resistant prostate cancer following renal transplantation

Prostate cancer (CaP) is currently the most frequently diagnosed cancer in men in the United States.An increase in the incidence of cancer with viral etiologies is observed in transplant patients who undergo immunosuppression as part of transplant management.What is less well understood is the effect of immunosuppression on the development and progression of CaP, particularly its effects on advanced disease.Additionally, there is little in the published literature regarding potential for drug-drug interactions between immunosuppressant medications and commonly used chemotherapeutic agents for advanced CaP.We found conflicting evidence regarding the effects of immunosuppression on prostate cancer development and progression, and particularly important for our case is the lack of evidence as to how it can alter progression of metastatic castrate resistant disease.Further, we found limited evidence of significant drug interactions between the currently used chemotherapy agents and immunosuppressant medications.As the survivorship of both transplant patients and patients with advanced CaP continue to improve, practitioners will have to become increasingly comfortable with the management of patients with both diseases.