Focus on skin cancer association and progression under TNF antagonist therapy

Area of Science:

• Dermatology
• Oncology
• Immunology

Background:

• Basal cell carcinoma and squamous cell carcinoma are the most common human non-melanoma skin cancers (NMSC).
• NMSC prevalence is higher in immunocompromised individuals.
• Tumor necrosis factor (TNF) has demonstrated roles in both tumor promotion and apoptosis induction in animal models.

Purpose of the Study:

• To investigate the potential association between TNF antagonist therapy and the development or progression of human skin cancers.
• To review existing literature on the effects of TNF antagonists on non-melanoma skin cancers, melanoma, and benign melanocytic tumors.

Main Methods:

• A review of peer-reviewed articles concerning human skin cancers potentially linked to TNF antagonists.
• Analysis of reported cases of NMSC and other skin malignancies in patients undergoing TNF antagonist therapy.
• Consideration of confounding factors such as cumulative co-exposures and other patient therapies.

Main Results:

• Some patient reports suggest an increased occurrence and altered growth kinetics of NMSC in individuals treated with TNF antagonists.
• There are suggestions of increased risk for other skin malignancies, including malignant melanoma, and benign melanocytic tumors.
• Most current evidence consists of anecdotal case reports, necessitating cautious interpretation.

Conclusions:

• Further research is essential to definitively establish and comprehend the risks associated with anti-TNF biologicals concerning human skin cancers.
• Current observations suggest that NMSC progression may be enhanced in areas of skin field cancerization.
• The development of benign melanocytic nevi is also a potential outcome observed during anti-TNF therapy.