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

Florian Poullenot 1 Philippe Seksik 2, 3, 4 Laurent Beaugerie 2, 3, 4 Aurélien Amiot 5 Maria Nachury 6 Vered Abitbol 7, 8 Carmen Stefanescu 9 Catherine Reenaers 10 Mathurin Fumery 11, 12 Anne-Laure Pelletier 13 Stéphane Nancey 14, 15 Laurent Peyrin-Biroulet 16, 17 Arnaud Bourreille 18, 19 Xavier Hébuterne 20 Hedia Brixi 21 Guillaume Savoye 22, 23, 24 Nelson Lourenço 25 Romain Altwegg 26 Anthony Buisson 27 Christine Cazelles-Boudier 28 Antoine Racine 29 Julien Vergniol 30, 31 David Laharie 30, 31 Groupe d'Etude Thérapeutique Des Affections Getaid 32
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.
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Submitted on : Tuesday, October 22, 2019 - 4:16:30 PM
Last modification on : Sunday, October 25, 2020 - 7:06:31 AM

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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, Lippincott, Williams & Wilkins, 2016, 22 (6), pp.1362-1369. ⟨10.1097/mib.0000000000000741⟩. ⟨hal-02326930⟩

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