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Anti-TNF therapy and malignancy - a critical review.
1Fox Chase Cancer Center, Philadelphia, USA. RB_Cohen@fcc.edu
Summary
Tumour necrosis factor (TNF) and anti-TNF therapies, like infliximab, are reviewed for cancer risk. Current data do not show a direct link between blocking TNF and developing cancers in patients with inflammatory diseases.
Area of Science:
- Immunology
- Oncology
- Pharmacology
Background:
- Inflammatory diseases increase baseline cancer risk.
- Tumour necrosis factor (TNF) plays a role in inflammation and immunity.
- Anti-TNF therapies are used to treat various inflammatory conditions.
Purpose of the Study:
- To review the role of TNF and anti-TNF therapy in malignancy.
- To assess cancer incidence in patients receiving anti-TNF therapy, specifically infliximab.
- To evaluate the potential causal relationship between TNF antagonism and cancer development.
Main Methods:
- Review of preclinical data on TNF antagonism and cancer.
- Analysis of clinical trial data for infliximab, focusing on malignancy incidence.
- Examination of baseline risk factors for malignancy in inflammatory diseases.
Main Results:
- Review covers baseline malignancy risks in inflammatory diseases.
- Clinical trials of infliximab were analyzed for cancer occurrences.
- Preclinical and early clinical data for infliximab do not indicate a causal link.
Conclusions:
- TNF antagonism, as seen with infliximab, has not been causally linked to lymphoid or nonlymphoid cancers based on current evidence.
- Further monitoring may be warranted, but existing data do not support a direct carcinogenic effect of anti-TNF therapy.