Risk of Incident Cancer in Inflammatory Bowel Disease Patients Starting Anti-TNF Therapy While Having Recent Malignancy - Normandie Université Access content directly
Journal Articles Inflammatory Bowel Diseases Year : 2016

Risk of Incident Cancer in Inflammatory Bowel Disease Patients Starting Anti-TNF Therapy While Having Recent Malignancy

1 CHU Bordeaux
2 UPMC - Université Pierre et Marie Curie - Paris 6
3 ERL INSERM U1157 - CNRS UMR 7203 - Microorganismes et physiopathologie intestinale
4 CHU Saint-Antoine [AP-HP]
5 Service d'hépato-gastro-entérologie [APHP Henri Mondor]
6 CHRU Lille - Centre Hospitalier Régional Universitaire [CHU Lille]
7 UPD5 - Université Paris Descartes - Paris 5
8 Service de Gastro-entérologie [CHU Cochin]
9 Service de Gastroentérologie [Hôpital Beaujon]
10 Université de Liège
11 Service d'Hépato Gastroenterologie [CHU Amiens-Picardie]
12 UPJV - Université de Picardie Jules Verne
13 AP-HP - Hôpital Bichat - Claude Bernard [Paris]
14 CIRI - Centre International de Recherche en Infectiologie
15 HCL - Hospices Civils de Lyon
16 NGERE - Nutrition-Génétique et Exposition aux Risques Environnementaux
17 Service d'Hépato-gastro-entérologie [CHRU Nancy]
18 Institut des Maladies de l'Appareil Digestif
19 CHU Nantes - Centre Hospitalier Universitaire de Nantes
20 CHU - Hôpital Archet 2 [Nice]
21 Hôpital Robert Debré
22 Service d'Hépato-Gastroentérologie [CHU Rouen]
23 ADEN - Nutrition, inflammation et dysfonctionnement de l'axe intestin-cerveau
24 UNIROUEN UFR Santé - UNIROUEN - UFR Santé
25 AP-HP - Hopital Saint-Louis [AP-HP]
26 CHU Montpellier
27 M2iSH - Microbes, Intestin, Inflammation et Susceptibilité de l'Hôte
28 CHCB - Centre Hospitalier de la Côte Basque
29 Hôpital Bicêtre
30 Hôpital Haut-Lévêque [CHU Bordeaux]
31 UB - Université de Bordeaux
32 GETAID - Groupe d’Étude Thérapeutique des Affections Inflammatoires du Tube Digestif
Florian Poullenot
  • Function : Author
Romain Altwegg
  • Function : Author
Antoine Racine
  • Function : Author

Abstract

Background:Patients with inflammatory bowel disease (IBD) and history of malignancy within the last 5 years are usually contraindicated for receiving anti-tumor necrosis factor (anti-TNF) agents. The aim of this study is to assess survival without incident cancer in a cohort of IBD patients exposed to anti-TNF while having previous malignancy within past 5 years.Methods:Data from IBD patients with previous malignancy diagnosed within the last 5 years before starting an anti-TNF agent were collected through a Groupe d'Etude Therapeutiques des Affections Inflammatoires du tube Digestif multicenter survey. Inclusion date corresponded to the first anti-TNF administration after cancer diagnosis.Results:Twenty centers identified 79 cases of IBD patients with previous malignancy diagnosed 17 months (median; range: 1-65) before inclusion. The most frequent cancer locations were breast (n = 17) and skin (n = 15). After a median follow-up of 21 (range: 1-119) months, 15 (19%) patients developed incident cancer (8 recurrent and 7 new cancers), including 5 basal-cell carcinomas. Survival without incident cancer was 96%, 86%, and 66% at 1, 2, and 5 years, respectively. Crude incidence rate of cancer was 84.5 (95% CI, 83.1-85.8) per 1000 patient-years.Conclusions:In a population of refractory IBD patients with recent malignancy, anti-TNF could be used taking into account a mild risk of incident cancer. Pending prospective and larger studies, a case-by-case joint decision taken with the oncologist is recommended for managing these patients in daily practice.

Dates and versions

hal-02326930 , version 1 (22-10-2019)

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Florian Poullenot, Philippe Seksik, Laurent Beaugerie, Aurélien Amiot, Maria Nachury, et al.. Risk of Incident Cancer in Inflammatory Bowel Disease Patients Starting Anti-TNF Therapy While Having Recent Malignancy. Inflammatory Bowel Diseases, 2016, 22 (6), pp.1362-1369. ⟨10.1097/mib.0000000000000741⟩. ⟨hal-02326930⟩
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