The risk of malignancy or progression of existing malignancy in patients with psoriasis treated with biologics: case report and review of the literature

Abstract

There is some debate regarding the risk of developing malignancy and progression of malignancy in patients with psoriasis treated with biologics. The lack of extensive, long-term, and large studies, including patients with psoriasis, to assess these aforementioned risks makes it difficult to ascertain the safety profile of biologic therapy in these patients. Several studies do support the favorability of the safety profile of biologics in patients with psoriasis in terms of the risk of developing malignancy. A few studies include patients with a previous history of cancer that were thereafter treated with biologics and show no increased risk of recurrence in those treated with biologics compared to non-biologic therapy. Although recent studies do not show an increased risk of new or recurrent malignancy in patients with psoriasis treated with biologic agents, there is still hesitancy in the widespread use of biologic agents in these patients. Considering all of the current data and opinions, the benefits of biologic therapy to improve quality of life often outweigh the negligible risk of solid organ malignancy associated with biologics in patients with existing or previous malignancies. Coordinating the management of patients that develop or have a history of previous malignancy with an oncology team is crucial for patient-centered care until clear evidence-based guidelines are developed.

A real‐life experience of psoriatic patients with history of cancer treated with biological drugs

“…Patients with a history of malignancy who started or resumed psoriasis therapy, time between diagnosis and therapy, duration of follow-up and outcomes One case report describes a patient taking etanercept after diagnosis and surgical treatment of a colon cancer with liver metastasis. 9 A study performed in patients affected by rheumatoid arthritis shows that patients with a prior malignancy receiving anti-TNF therapy are not exposed to an increased risk of new malignancy after an average of 3 years of follow-up. 6 It is well known that psoriasis may cause low self-esteem and social withdrawal due to stigmatization and rejection.…”

Risk of malignancy in psoriatic patients: Our clinical experience

“…Moreover, this risk seems to be increased in patients with a more severe psoriasis (Patel, Patel, & Kerdel, 2016), frequently treated for a long period.…”

Monoclonal antibodies for the treatment of plaque psoriasis

“…20 Recent reviews suggest the available evidence does not show that the anti-TNF or anti-interleukin agents are associated with an increased risk of malignancy in patients with psoriasis, though the risk with newer agents is presently unknown. 21,22 Concern remains about the possibility of reactivating latent infection and an increased risk of viral infection due to immunosuppression. 21 The risk of serious adverse events in 'real-world' settings might be higher than suggested by clinical trials due to the exclusion of patients with risk factors from the latter.…”