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Do tumor necrosis factor inhibitors increase cancer risk in patients with chronic immune-mediated inflammatory

Yuehong Chen1, Marcia Friedman2, Gang Liu1

  • 1Department of Rheumatology and Immunology, West China Hospital, Sichuan University, 37 Guoxue Xiang, Chengdu, Sichuan 610041, China.

Cytokine
|October 1, 2016
PubMed

Insights

Tumor necrosis factor inhibitors (TNFi) are used for inflammatory diseases but raise malignancy concerns. This review found TNFi use is not linked to higher risks of overall cancer, lymphoma, or melanoma, though NMSC risk requires further study.

Area of Science:

  • Immunology
  • Oncology
  • Pharmacology

Background:

  • Tumor necrosis factor (TNF) inhibitors (TNFi) have improved treatment for immune-mediated inflammatory diseases.
  • A potential concern with TNFi therapy is an increased risk of malignancy.
  • Understanding cancer incidence in TNFi users is crucial for patient safety.

Purpose of the Study:

  • To systematically review and analyze cancer incidence and risks in patients using TNFi.
  • To assess malignancy risks across different indications, cancer types, and specific TNFi agents.

Main Methods:

  • Systematic review of studies reporting cancer incidence and risks in TNFi users.
  • Analysis of data from patients with rheumatoid arthritis (RA) and inflammatory bowel diseases (IBD).
  • Comparison of cancer rates in TNFi users versus non-users and the general population.

Main Results:

  • Cancer incidence varied significantly across studies, indications, and cancer types.
  • TNFi use was not associated with increased risks of overall cancer, lymphoma, or melanoma compared to non-users.
  • Elevated incidences of lymphoma in RA patients and non-melanoma skin cancer (NMSC) in RA, IBD, and psoriasis patients were observed compared to the general population.
  • NMSC risk findings were inconsistent, with some studies suggesting a small increased risk of squamous cell carcinoma in RA patients on TNFi.

Conclusions:

  • TNFi therapy does not appear to elevate the risk of overall cancer, lymphoma, or melanoma.
  • While NMSC risk requires further investigation, current evidence is inconsistent.
  • Prospective studies are needed to clarify the association between TNFi use and NMSC risk.
Keywords:
Immune-mediated inflammatory diseasesMalignancyTumor necrosis factor inhibitors

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