期刊
CLINICAL GASTROENTEROLOGY AND HEPATOLOGY
卷 20, 期 1, 页码 88-95出版社
ELSEVIER SCIENCE INC
DOI: 10.1016/j.cgh.2020.10.007
关键词
Cancer Recurrence; Biologics; IBD
资金
- Crohns and Colitis Foundation
- Chleck Family Foundation
- Pfizer
This retrospective study compared the risk of new or recurrent cancers in IBD patients with prior malignancy who were treated with Vedolizumab (VDZ), TNF-antagonists, or no immunosuppressive therapy. The results showed that neither VDZ nor TNF-antagonists were associated with an increased risk of new or recurrent cancers in these patients.
BACKGROUND & AIMS: Treatment of patients with inflammatory bowel diseases (IBD; Crohn's disease (CD), ulcerative colitis (UC) who have a prior history of cancer pose a unique challenge. The impact of Vedolizumab (VDZ) on the risk of new or recurrent cancers in patients with a previous malignancy is unknown. METHODS: was a retrospective study of patients with IBD with a history of current or prior cancer who were subsequently initiated on VDZ, tumor necrosis factor alpha antagonists (anti-TNF), or had no immunosuppressive therapy after the index cancer diagnosis. The occurrence of a new primary cancer or recurrent cancer was ascertained on follow-up. Multivariable Cox-proportional hazard models were used to determine the independent effect of post-cancer treatment on new/recurrent cancer. RESULTS: The study included 96 patients exposed to VDZ after a prior diagnosis of cancer who were compared to 184 and 183 patients exposed to anti-TNF or no immunosuppressive therapy, respectively. The most common primary cancer were solid tumors (50%). Over a median of 6.2 person-years of follow-up, 18 patients on VDZ developed new (7) or recurrent (11) cancer corresponding to a rate of 22 per 1000 person-years after cancer diagnosis. In a multivariable Cox-model, after adjusting for confounders, there was no increase in the risk of new or recurrent cancer with VDZ (HR 1.38 95% CI 0.38 - 1.36) or anti-TNF therapy (HR 1.03, 95% CI 0.65 - 1.64), when compared to no IS. CONCLUSIONS: Neither Vedolizumab nor TNF-antagonists were associated with increased risk of new or recurrent cancers in patients with prior malignancy.
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