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The work highlights clinical need for immunosuppressants that combine tumor-suppressing and immune-modulating effects, noting examples such as mTOR inhibitors and potential immunosuppressive activity of capecitabine. The review focuses on therapeutic options for transplant patients at elevated risk of tumor occurrence or recurrence.",{"@graph":69,"@context":123},[70,84,106],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":35,"@type":76,"position":81},"https://docshare.wps.com/document/healthcare/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/transplant-oncology-and-anticancer-immunosuppressants/374032/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/transplant-oncology-and-anticancer-immunosuppressants/374032.png","ImageObject",300,407,{"name":92,"@type":93},"Patrick","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-10-27","2026-09-23",true,{"@type":102,"interactionType":103,"userInteractionCount":105},"InteractionCounter",{"@type":104},"ViewAction",17,{"@type":107,"mainEntity":108},"FAQPage",[109,115,119],{"name":110,"@type":111,"acceptedAnswer":112},"Why does immunosuppressive therapy increase cancer risk after organ transplantation?","Question",{"text":113,"@type":114},"Long-term immunosuppression prevents allogeneic graft rejection but reduces immune surveillance of neoplastic cells. It also promotes opportunistic infections, including viral infections, which can contribute to malignancy risk.","Answer",{"name":116,"@type":111,"acceptedAnswer":117},"What is transplant oncology and what does it cover?",{"text":118,"@type":114},"Transplant oncology integrates oncology and immunology with transplantation care. It includes surgical aspects plus comprehensive management before and after transplant, grounded in multidisciplinary investigation of disease mechanisms and tumor/transplant immunology.",{"name":120,"@type":111,"acceptedAnswer":121},"What is the recurrence rate of hepatocellular carcinoma after liver transplantation and why is it challenging?",{"text":122,"@type":114},"Recurrence occurs in about 6%–18% of patients transplanted for hepatocellular carcinoma. 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Immunol. 15:1520083 .  \ndoi: 10.3389/fimmu.2024.1520083  \nCOPYRIGHT  \n© 2025 Kong, Duan, Chen, Wang, Ren, Lu, Chen, Song, Wu, Chang, Yin, Shen and Zheng. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY) . The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.  \nTransplant oncology and anticancer immunosuppressants  \nDejun Kong 1†, Jinliang Duan 1†, Shaofeng Chen 1†, Zhenglu Wang 2,3, Jiashu Ren 4, Jianing Lu 4, Tao Chen 1, Zhuolun Song 2, Di Wu 2, Yuan Chang 1, Zhongqian Yin 4, Zhongyang Shen 2,3,5,6 and Hong Zheng 2,3,5,6*  \n1 Nankai University School of Medicine, Tianjin, China, 2Tianjin Organ Transplantation Research Center, Tianjin First Central Hospital, Nankai University School of Medicine, Tianjin, China, 3 Key Laboratory of Transplant Medicine, Chinese Academy of Medical Sciences, Tianjin, China, 4Tianjin First Central Clinical College, Tianjin, China, 5 Research Institute of Transplant Medicine, Nankai University, Tianjin, China, 6Tianjin Key Laboratory for Organ Transplantation, Tianjin, China  \nOrgan transplantation is a life-saving intervention that enhances the quality of life for patients with end-stage organ failure. However, long-term immunosuppressive therapy is required to prevent allogeneic graft rejection, which inadvertently elevates the risk of post-transplant malignancies, especially for liver transplant recipients with a prior history of liver cancer. In response, the emerging field of transplant oncology integrates principles from oncology and immunology to improve outcomes for patients at high risk of tumor occurrence or recurrence following transplantation. Therefore, it is of substantial clinical significance to develop immunosuppressants that possess both immunosuppressive and anti-tumor properties. For instance, mTOR inhibitors demonstrate anti-tumor effects among antimetabolite immunosuppressive drugs, and recent studies indicate that capecitabine, an antimetabolite chemotherapeutic, may also exhibit immunosuppressive activity in the clinic for liver transplants suffering from hepatocellular carcinoma . This review systematically explores potential immunosuppressants with dual anti-tumor and immunosuppressive effects to support the management of transplant patients at elevated risk of tumor occurrence or recurrence.  \nKEYWORDS  \norgan transplantation, transplant oncology, immunosuppressant, anti-metabolic drugs, anti-tumor  \n1 Introduction  \nOrgan transplantation is the only way to extend the lives of many patients with end-stage organ failure. In 1963, Starzl et al. performed the first orthotopic liver transplantation, introducing the concept that primary liver malignancies unresponsive to conventional techniques, such as subtotal liver resection, should be considered for total hepatectomy and liver transplantation (1). Although transplant oncology is not a new concept, it has recently  \nFrontiers in Immunology 01 [frontiersin.org](frontiersin.org)  \nregaine","cbCaickLOrzTAS6B","https://ap.wps.com/l/cbCaickLOrzTAS6B","pdf",1165308,13,"English","# Introduction\n## Background on transplant oncology\n## Risks of post-transplant malignancy\n## Recurrence after liver transplantation","[{\"question\":\"Why does immunosuppressive therapy increase cancer risk after organ transplantation?\",\"answer\":\"Long-term immunosuppression prevents allogeneic graft rejection but reduces immune surveillance of neoplastic cells. It also promotes opportunistic infections, including viral infections, which can contribute to malignancy risk.\"},{\"question\":\"What is transplant oncology and what does it cover?\",\"answer\":\"Transplant oncology integrates oncology and immunology with transplantation care. It includes surgical aspects plus comprehensive management before and after transplant, grounded in multidisciplinary investigation of disease mechanisms and tumor/transplant immunology.\"},{\"question\":\"What is the recurrence rate of hepatocellular carcinoma after liver transplantation and why is it challenging?\",\"answer\":\"Recurrence occurs in about 6%–18% of patients transplanted for hepatocellular carcinoma. Although partially predictable, early detection and established guidelines remain limited, and cancers may behave more aggressively under the transplant setting.\"}]","Transplant oncology and anticancer immunosuppressants | PDF",1790201051,33]