A Multidisciplinary Approach to Patients with Psoriasis and a History of Malignancies or On-Treatment for Solid Tumors: A Narrative Literature Review
Abstract
:1. Introduction
- Can people suffering from psoriasis who have had cancer in the past receive biologics treatment?
- Is there a safe time frame?
- Can we treat psoriasis patients with biologics while undergoing cancer treatment?
- What is the relationship between anticancer medications and exacerbations of psoriasis?
2. Methods
3. Results
3.1. Cytokines in Psoriasis and Cancer Microenvironment
3.2. TNF
3.3. IL-17 Microenvironment and Psoriasis
3.4. IL-23 Microenvironment and Psoriasis
3.5. Treatment Monitoring Recommendation and Specific Comorbidity
4. Discussion
4.1. Can We Treat with Biologics Patients with a History of Malignancies?
4.2. Is There a Timing?
4.3. Can We Treat Psoriatic Patients during Anticancer Treatment? Are There Drugs More Involved in Psoriasis Exacerbations?
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Conflicts of Interest
References
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Biological Drug | Mechanism of Action | FDA Approval for Psoriasis |
---|---|---|
Etanercept | Anti-TNFα | 2004 |
Infliximab | Anti-TNFα | 2006 |
Adalimumab | Anti-TNFα | 2008 |
Certolizumab-pegol | Anti-TNFα | 2008 |
Golimumab | Anti-TNFα | 2009 |
Ustekinumab | Anti p40 IL-12/IL-23 | 2009 |
Secukinumab | Anti-IL-17A | 2015 |
Ixekizumab | Anti-IL-17A | 2016 |
Brodalumab | Anti-IL-17RA | 2017 |
Guselkumab | Anti-p19 IL-23 | 2017 |
Tildrakizumab | Anti-p19 IL-23 | 2018 |
Risankizumab | Anti-IL-23A | 2022 |
Bimekizumab | IL-17A/F | 2023 |
Studies | N° pts | Drugs | Timing from Diagnosis to Treatment | Recurrence or Progression | Follow-Up Duration | New Primary Tumors |
---|---|---|---|---|---|---|
Odorici G [34] | 14 | Anti-TNFα, Anti-IL-12/23, anti-IL-17; anti-IL-23. | 3.6 y | No recurrence or progression | 34 months | (1 SCLC, 1 multiple myeloma, 1 NMSC) |
Kahn JS [35] | 16 | Apremilast, Anti-TNFα, Anti-IL-12/23, anti-IL-17; anti IL-23. | 4.7 y | No recurrence or progression | Retrospective | None |
Mastorino L [36] | 37 | Anti-TNFα, Anti-IL-12/23, anti-IL-17; anti-IL-23. | 7 y | No progression. 1 endometrial cancer recurrence | 33 months | None |
Mastorino L [37] | 7 | Anti-IL-23, | 3–20 y | No recurrence or progression | 11–15 months | 1 NMSC |
Bellinato F [38] | 12 | Anti—IL-17 | 15 m | No recurrence, 2 disease progression | 46 months | None |
Valenti M [39] | 16 | Anti-TNFα, Anti-IL-12/23, anti-IL-17; anti-IL-23. | 5–10 y | No recurrence | 22 months | None |
Pellegrini C [40] | 42 | Anti-IL-17 | 3.5 y | No recurrence, 2 progressions in metastatic disease | 12 months | (1 SCLC, 1 1 breast cancer, 1 glioblastoma) |
Studies | N° pts | Drugs | Recurrence or Progression | New Primary Tumors |
---|---|---|---|---|
Augustin M [41] | 1756 | Secukinumab | No recurrence or progression. | NR |
Lebwohl M [42] | 10,685 | Secukinumab | No recurrence or progression. | EAIR of malignancy was 0.85/100 PTY, corresponding to 204 patients per 23 908 PY |
Blauvelt A [43] | 1721 | Guselkumab | No recurrence or progression. | EAIR of malignancy was 0.74/100 PY, corresponding to 53 patients per 7117 PY |
[44] | 112 studies including 2,053,932 patients | Patients receiving biologic therapy and non-biologic therapy | No recurrence or progression. | No increase in cancer was seen among patients with psoriasis treated with biologic agents |
Gupta A [45] | 31 studies, 24,328 persons | Patients receiving biologic therapy and non-biologic therapy | Rates of cancer recurrence were similar among individuals not on immunosuppression, receiving an anti-TNF, immunomodulators, or combination immunosuppression. Patients receiving ustekinumab and vedolizumab had lower rates of cancer. | NR |
Smith SD [46] | 17 studies, including 6892 patients | Ixekizumab | 55 patients developed NMSC, 1 melanoma, 1 dermatofibrosarcoma protuberans | |
Gottlieb A 2022 [47] | 8891 | Secukinumab | EAIR/100PY 224 (PsO) EAIR/100PY 159.2 (PsA) EAIR/100PY 125.5 (AS) | NR |
Jung JM [48] | 191,678 | TNF-α inhibitor/IL12/23 inhibitor | SIR, 1.12; 95% (CI 1.09–1.14). TNF-α inhibitor (aHR 1.41; 95% CI 1.01–1.97). IL-12/23 inhibitor (aHR, 0.57; 95% CI 0.37–0.87). | NR |
Gargiulo L 2023 [49] | 606 | Brodalumab | The log-rank test and Cox regression did not detect any differences in drug survival regarding BMI classes, comorbidities, involvement of difficult-to-treat areas, and previous exposure to biologics | 1 prostate cancer 1 breast cancer, (after 16 weeks of treatment) they both stopped brodalumab to undergo surgery |
Hellgren K [50] | 55,850 | TNF-α inhibitor | HR for solid cancer overall was 1.0 (0.9–1.2) for TNFi-exposed vs biologics-naïve PsA | NR |
Study | Pts/Biologics | Prior Diagnosis of Neoplasm ≥ 5 y | Prior Diagnosis of Neoplasm ≥ 10 y | Neoplasm after Biologics | Biologics Start after Prior Neoplasm | Biologics Start during Anti Neoplastic Treatment | Effect |
---|---|---|---|---|---|---|---|
Vodouri D [56] | 5 (P) | Y | N | N | N | Y | Exacerbations |
Bonigen J [57] | 21 (P) | Y | N | N | N | Y | De novo 90 d pre-existing 33 d |
Johnson D [58] | 1 (P) | N | N | N | N | Y | Stop pembrolizumab for psoriasis started sekukinumab succumbed |
Esfahani K [59] | 1 (P) | Y | N | N | Y | Y | Stop pembrolizumab progression |
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Denaro, N.; Nazzaro, G.; Murgia, G.; Scarfì, F.; Cauchi, C.; Carrera, C.G.; Cattaneo, A.; Solinas, C.; Scartozzi, M.; Marzano, A.V.; et al. A Multidisciplinary Approach to Patients with Psoriasis and a History of Malignancies or On-Treatment for Solid Tumors: A Narrative Literature Review. Int. J. Mol. Sci. 2023, 24, 17540. https://doi.org/10.3390/ijms242417540
Denaro N, Nazzaro G, Murgia G, Scarfì F, Cauchi C, Carrera CG, Cattaneo A, Solinas C, Scartozzi M, Marzano AV, et al. A Multidisciplinary Approach to Patients with Psoriasis and a History of Malignancies or On-Treatment for Solid Tumors: A Narrative Literature Review. International Journal of Molecular Sciences. 2023; 24(24):17540. https://doi.org/10.3390/ijms242417540
Chicago/Turabian StyleDenaro, Nerina, Gianluca Nazzaro, Giulia Murgia, Federica Scarfì, Carolina Cauchi, Carlo Giovanni Carrera, Angelo Cattaneo, Cinzia Solinas, Mario Scartozzi, Angelo Valerio Marzano, and et al. 2023. "A Multidisciplinary Approach to Patients with Psoriasis and a History of Malignancies or On-Treatment for Solid Tumors: A Narrative Literature Review" International Journal of Molecular Sciences 24, no. 24: 17540. https://doi.org/10.3390/ijms242417540