Biological therapy and recurrent cancer: a threat no more?

Menée au Danemark à partir de données portant sur 25 738 patients atteints d'une maladie liée au système immunitaire (maladie inflammatoire de l'intestin, polyarthrite rhumatoïde, psoriasis) et ayant des antécédents de cancer diagnostiqué entre 1999 et 2016, cette étude de cohorte analyse l'association entre un traitement par inhibiteurs du facteur de nécrose tumorale alpha et le risque de récidive de cancer ou le risque de développer un nouveau cancer primitif (période de suivi : 18 752 personnes-années)

Résumé en anglais

The advent of monoclonal antibody therapies (frequently called biologics) heralded a new era of treatment for immune-mediated conditions. Unlike their immunomodulator predecessors, biological therapies target specific molecules in the inflammation pathway and are more effective at controlling inflammation. This new class of immunosuppressants also upended conventional wisdom that more potent medications carry greater risk; biological therapies instead seemed safer than thiopurines and corticosteroids. Nonetheless, because they are potent immunosuppressants, it is not a trivial matter to prescribe biological therapies. Safety considerations still exist that are related to increased risk of infections, bone marrow suppression, and idiosyncratic allergic reactions, among others. Given how the immune system helps to inhibit growth of malignant cells, biological therapies also pose the theoretical risk of facilitating carcinogenesis