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Meta-Analysis of Voriconazole Exposure and Risk of Cutaneous SCC

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Key Points

  • Use of vorinconazole was associated with increased risk of SCC.
  • Increased risk did not differ by type of transplant or after adjustment for sun exposure.
  • Voriconazole use was not associated with an increased risk of basal cell carcinoma.

Voriconazole is an antifungal medication that is sometimes used to treat fungal infection in immunocompromised patients, including patients undergoing various transplants. In order to better assess the risk associated with voriconazole use after lung or hematopoietic stem cell transplant and development of cutaneous squamous cell carcinoma (SCC), researchers performed a meta-analysis of published literature. Their findings on the relationship were published by Tang et al in the Journal of the American Academy of Dermatology.

Meta-Analysis Results

Researchers searched PubMed and Embase and performed a random effects model meta-analysis to calculate pooled relative risk (RR) of the development of SCC after voriconazole exposure.

Of 8 studies with a total of 3,710 patients who underwent lung transplant or hematopoietic stem cell transplant, 5 studies were included in the meta-anslysis. Use of vorinconazole was associated with an increased risk of SCC (RR = 1.86; 95% confidence interval [CI] = 1.36–2.55). Increased risk did not differ by type of transplant or after adjustment for sun exposure.

Longer duration of vorinconazole use was associated with an increased risk of SCC (RR = 1.72; 95% CI = 1.09–2.72). Voriconazole use was not associated with increased risk of basal cell carcinoma (RR = 0.84; 95% CI= 0.41–1.71).

The authors concluded, “Our findings support an increased risk of SCC associated with voriconazole in individuals with a lung transplant or hematopoietic cell transplant. Routine dermatologic surveillance should be performed, especially among individuals at high risk of developing SCC.”

Disclosure: See study authors’ full disclosures at jaad.org.

The content in this post has not been reviewed by the American Society of Clinical Oncology, Inc. (ASCO®) and does not necessarily reflect the ideas and opinions of ASCO®.


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