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No increased risk of cancer following immunosuppression for patients with IBD, cancer history
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ORLANDO, Fla. — Although nearly 30% of patients with inflammatory bowel disease and a history of cancer develop an incident cancer, there does not seem to be a connection between their IBD treatment and subsequent cancer development, according to a presenter here.
“Nearly 30% of all IBD patients with a history of cancer developed a secondary or recurrent cancer,” Jordan E. Axelrad, MD, MPH, of the Icahn School of Medicine at Mount Sinai, said during the Advances in IBD Meeting. “However, exposure to immunosuppression … was not associated with subsequent cancer.”
In this retrospective, multicenter study, Axelrad and colleagues looked at 185 patients with IBD and a history of cancer from the Massachusetts General Hospital, New York University Langone Medical Center and the Mount Sinai Hospital. They identified 65 patients exposed to anti-tumor necrosis factor-alpha after their diagnosis of cancer, the anti-TNF-a arm; 46 to thiopurines or methotrexate, the antimetabolite arm; and 74 without subsequent immunosuppression exposure, the control arm. Researchers calculated time to incident cancer from the date of an initial cancer diagnosis to the date of recurrence, new malignancy or last clinical encounter.
Of these, 27 (36.5%) in the control group, 12 (26.1%) in the antimetabolite group and 14 (21.5%) in the anti-TNF-a group developed incident cancer.
The incident cancer rates were as follows:
Control group: 3.9 with 361 person-years of follow-up
Antimetabolites group: 6.6 with 181 person-years of follow-up
Anti-TNF-a group: 8.8 with 306 person-years of follow-up
After 5 years, there was no significant difference in cancer-free survival between the groups. There was also no significant difference between types of cancer developed in the treatment groups.
Axelrad acknowledged the study’s limitations included the retrospective analysis, small sample size and medication data based on exposure, not dose or duration. Researchers are continuing to collect data through the newly formed New York Crohn’s and Colitis Organization (NYCCO), consisting of major academic medical centers in the New York City area, and expect more robust data soon, he said.
For more information:
Axelrad JE. O-005. Presented at: 2014 Advances in Inflammatory Bowel Diseases, Dec. 4-6, 2014; Orlando, Fla.
Disclosures: Axelrad reports no financial disclosures.