Tu1906 Risk of Cancer Recurrence Among Individuals Exposed to Anti-Tumor Necrosis Factor Therapy: A Meta-Analysis of Observational Studies

Micić, Dejan; Komaki, Yuga; Alavanja, Aleksandar; Rubin, David M.; Sakuraba, Atsushi

doi:10.1016/s0016-5085(16)33299-1

Cited by 3 publications

(3 citation statements)

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“…The most data exist for risk of cancer recurrence in patients with a history of cancer treated with TNFi for other immune-mediated conditions, including rheumatoid arthritis and inflammatory bowel disease (Table S3, Supplementary Material). These data include metaanalyses of up to 13,598 patients and 32,473 patient-years of follow-up, with no increased risk of cancer recurrence observed [82][83][84]. Although clinical trials exclude patients with a history of TSTs, long-term extensions and metaanalyses estimate baseline cancer risk with systemic treatments.…”

Section: Baseline Risk Of Cancer In Patients With Psoriasis and Its T...mentioning

confidence: 99%

Use of Systemic Therapies for Treatment of Psoriasis in Patients with a History of Treated Solid Tumours: Inference-Based Guidance from a Multidisciplinary Expert Panel

Papp

Melosky

Sehdev

et al. 2023

Dermatol Ther (Heidelb)

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Background Patients with treated solid tumours (TSTs) are a highly heterogeneous population at an increased risk for malignancy compared with the general population. When treating psoriasis in patients with a history of TSTs, clinicians are concerned about the immunosuppressive nature of psoriasis therapies, the possibility of augmenting cancer recurrence/progression, and infectious complications. No direct, high-level evidence exists to address these concerns. Objectives We aim to provide a structured framework supporting healthcare professional and patient discussions on the risks and benefits of systemic psoriasis therapy in patients with previously TSTs. Our goal was to address the clinically important question, “In patients with TSTs, does therapy with systemic agents used for psoriasis increase the risk of malignancy or malignancy recurrence?” Methods We implemented an inference-based approach relying on indirect evidence when direct clinical trial and real-world data were absent. We reviewed indirect evidence supporting inferences on the status of immune function in patients with TSTs. Recommendations on systemic psoriasis therapies in patients with TSTs were derived using an inferential heuristic. Results We identified five indirect indicators of iatrogenic immunosuppression informed by largely independent bodies of evidence: (1) overall survival, (2) rate of malignancies with psoriasis and systemic psoriasis therapies, (3) rate of infections with psoriasis and systemic psoriasis therapies, (4) common disease biochemical pathways for solid tumours and systemic psoriasis therapies, and (5) solid organ transplant outcomes. On the basis of review of the totality of this data, we provided inference-based conclusions and ascribed level of support for each statement. Conclusions Prior to considering new therapies for psoriasis, an understanding of cancer prognosis should be addressed. Patients with TSTs and a good cancer prognosis will have similar outcomes to non-TST patients when treated with systemic psoriasis therapies. For patients with TSTs and a poor cancer prognosis, the quality-of-life benefits of treating psoriasis may outweigh the theoretical risks. Supplementary Information The online version contains supplementary material available at 10.1007/s13555-023-00905-3.

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Section: Baseline Risk Of Cancer In Patients With Psoriasis and Its T...mentioning

confidence: 99%

Use of Systemic Therapies for Treatment of Psoriasis in Patients with a History of Treated Solid Tumours: Inference-Based Guidance from a Multidisciplinary Expert Panel

Papp

Melosky

Sehdev

et al. 2023

Dermatol Ther (Heidelb)

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“…Regarding patients with a history of cancer, an SR and MA, including 3807 patients under anti-TNF therapy (with dermatological and non-dermatological disorders) versus 7972 controls, all those with a previous history of cancer, showed that the pooled RR of new or recurrent cancer was not significantly different between the groups (IRR 0.90; 95% CI 0.59-1.37) [28].…”

Section: Anti-tnfsmentioning

confidence: 94%

Biologics Versus JAK Inhibitors. Part I: Cancer Risk. A Narrative Review

Mansilla-Polo,

Morgado-Carrasco

2024

Dermatol Ther (Heidelb)

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Introduction Biological drugs (BD) and Janus kinase inhibitors (JAKi) have revolutionized the treatment of diverse dermatoses. However, there are concerns regarding their safety, especially the risk of cancer and opportunistic infections. Here, we discuss the risk of cancer associated with the BD and JAKi used in dermatology. Methods A narrative review was carried out. All relevant articles evaluating the risk of cancer associated with BD or JAKi and published between January 2010 and February 2024 were selected. Results Multiple large studies have evaluated the association between BD, JAKi and cancer risk. However, there is a lack of prospective, comparative studies. Overall, patients undergoing BD and JAKi present a cutaneous cancer incidence similar to that in the general population. The drugs more strongly associated with non-skin cancer risk were anti-tumor necrosis factor (anti-TNFs) agents and JAKi (especially tofacitinib and oral ruxolitinib). This risk appears to increase with age, the presence of other factors (such as chronic immunosuppression from previous drugs or other comorbidities), and specific diseases such as rheumatoid arthritis (RA) and myelodysplastic syndrome. Conversely, BD such as interleukin (IL)-17 and IL-23 inhibitors may even reduce the risk of some visceral and hematological malignancies. In patients with dermatological conditions such as psoriasis and atopic dermatitis, the risk of malignancies may be lower than in other subgroups, and probably comparable to the general population. Conclusions The incidence of cancer in patients undergoing BD or JAKi is generally low. This incidence can be higher in elderly patients with RA or myelodysplastic syndrome, and in those undergoing prolonged therapy with tofacitinib or ruxolitinib (oral), or anti-TNF agents.

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“…10 Patients with prior cancer who received anti-TNF therapy did not significantly increase their risk of developing new or recurrent cancer when compared to controls, according to a systematic review and meta-analysis of observational studies. 11…”

Section: Anti-tnf'smentioning

confidence: 99%

Current Treatment Strategies for Inflammatory Bowel Disease Patients at the Risk of Developing Cancer: A Comprehensive Review

Achutha,

Desai

2023

Journal of Coloproctology

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Inflammatory bowel disease (IBD) is a chronic condition that affects the digestive tract and can lead to inflammation and damage to the intestinal lining. IBD patients with cancer encounter difficulties since cancer treatment weakens their immune systems. A multidisciplinary strategy that strikes a balance between the requirement to manage IBD symptoms and the potential effects of treatment on cancer is necessary for effective care of IBD in cancer patients. To reduce inflammation and avoid problems, IBD in cancer patients is often managed by closely monitoring IBD symptoms in conjunction with the necessary medication and surgical intervention. Anti-inflammatory medications, immunomodulators, and biologic therapies may be used for medical care, and surgical options may include resection of the diseased intestine or removal of the entire colon. The current study provides a paradigm for shared decision-making involving the patient, gastroenterologist, and oncologist while considering recent findings on the safety of IBD medicines, cancer, and recurrent cancer risk in individuals with IBD. We hope to summarize the pertinent research in this review and offer useful advice.

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Tu1906 Risk of Cancer Recurrence Among Individuals Exposed to Anti-Tumor Necrosis Factor Therapy: A Meta-Analysis of Observational Studies

Cited by 3 publications

References 0 publications

Use of Systemic Therapies for Treatment of Psoriasis in Patients with a History of Treated Solid Tumours: Inference-Based Guidance from a Multidisciplinary Expert Panel

Use of Systemic Therapies for Treatment of Psoriasis in Patients with a History of Treated Solid Tumours: Inference-Based Guidance from a Multidisciplinary Expert Panel

Biologics Versus JAK Inhibitors. Part I: Cancer Risk. A Narrative Review

Current Treatment Strategies for Inflammatory Bowel Disease Patients at the Risk of Developing Cancer: A Comprehensive Review

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