ORLANDO – Immunosuppressive therapies were not associated with subsequent cancers in patients with inflammatory bowel disease who also had a history of cancer, a retrospective analysis showed.
In a review of 185 patient records from three sites chosen according to whether the person had both a history of cancer and a confirmed diagnosis of inflammatory bowel disease (IBD), patients had at least one follow-up visit after their respective cancer diagnosis.
There were three study arms: 65 patients who’d been treated for their IBD with anti–TNF-alpha immunosuppression, 46 patients who’d received antimetabolite immunosuppressive treatment, and 74 controls who’d not been exposed to immunosuppression. The primary outcome was the development of incident cancer, whether new or recurrent, as calculated from the date of the initial cancer diagnosis to the date of the recurrent or new malignancy or to the date of the patient’s last clinical visit.
Dr. Jordan Axelrad
Nearly a third of all patients developed incident cancer during the follow-up period, but there were not any statistically significant differences in incident rates between groups, Dr. Jordan Axelrad reported at a conference on inflammatory bowel diseases, sponsored by the Crohn’s & Colitis Foundation of America.
Just over 14% of all patients developed a new cancer, 12% developed a recurrent cancer, and slightly less than 3% developed both a new and recurrent cancer.
“There were qualitatively more skin cancers in the anti–TNF[-alpha] group, and more GI cancers in the control group,” said Dr. Axelrad of Mt. Sinai Hospital in New York.
Solid cancers occurred primarily in the control and antimetabolite groups, 46.4% and 46.2%, respectively. Hematologic cancers were least common, with none in the control group and one each in the study arms.
In addition, Dr. Axelrad said that at 5 years post follow-up, there was no significant difference in cancer-free survival rates between the three groups (P = .086).
Because the study was limited by a lack of data on any dose-related effects or periods of cancer remission, as well as the population size, Dr. Axelrad said he hoped a consortium effort by the New York Crohn’s and Colitis Organization, which includes Mt. Sinai, would help collect sufficient data to make future, higher-powered studies possible.
Dr. Axelrad said he had no relevant financial disclosures.
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