Jordan Axelrad, MD: Assessing the Risk of Cancer for IBD Patients

Exposure to some of the common therapeutics for inflammatory bowel disease (IBD) does not lead to worse outcomes for patients with a history of cancer.

In data presented during the 2023 Digestive Disease Week (DDW) in Chicago, a team of researchers led by Jordan Eric Axelrad, MD, MPH, NYU Langone Health, looked at retrospective studies for patients with IBD and a history of cancer to see if exposure to anti-TNF treatments and/or immunomodulator agents increased the overall risk of cancer recurrence or developing new cancers compared to patients who were not exposure to those medications.

In the study, the investigators looked at 306 patients with IBD and an index of cancer and looked at outcomes for several treatments, including anti-TNF (n = 98; 32%), vedolizumab (n = 91; 30%), immunomodulators (n = 74; 24%), ustekinumab (n = 58; 19%), and tofacitinib (n = 9; 3%). The results show 14% (n = 44) of patients developed 53 subsequent cancers, 25 new cancers and 287 recurrent cancers. This included 18 (34%) other solid, 25 (47%) dermatologic, 5 (9%) GI, and 1 (2%) hematologic malignancy.

However, overall there was not an increased risk of new or recurrent cancer with exposure to IMM monotherapy (9.2/100 person-years; risk ratio [RR] 1.39, 95% confidence interval [CI] 0.41-4.37), biologic monotherapy (7.8/100 person-years; RR 1.17, 95% CI 0.52-2.87), combination therapy with an IMM and a biologic (14.0/100 person-years; RR 2.10, 95% CI 0.83-5.57), or tofacitinib (11.2/100 person-years; RR 1.70, 95% CI 0.18-8.19).

In an interview with HCPLive®, Axelrad explained why it is important to consistently look at outcomes when it comes to IBD treatments.