Kahn Jared S., Casseres Rachel G., Her Min J., Dumont Nicole, Gottlieb Alice B., Rosmarin David
J Drugs Dermatol. 2019 Apr 1;18(4).
Introduction: Biologics have transformed the management of moderate-to-severe psoriasis. The risk of developing a malignancy during treatment is an important consideration, and many studies have been conducted to determine the magnitude of this risk. However, there is little research on the use of biologic treatment in psoriasis patients with a history of established malignancy. Methods: We preformed a retrospective chart review of patients with psoriasis and a history of malignancy that were treated with biologics or apremilast. A list was created containing the 690 patients with psoriasis who were treated in our clinic with biologics or apremilast between January 1st, 2012 and May 31, 2018. The charts were examined, and 16 patients were found to have a history of malignancy excluding non-melanoma skin cancer. Results: Sixteen patients met criteria to be included in this review. The average time from cancer diagnosis to initiation of biologics or apremilast was 4.7 years, and 9 patients (56%) started treatment within five years. Three patients (19%) received concurrent cancer therapy during biologic treatment. None of the 16 patients had recurrence or progression of their cancer noted clinically or radiographically during biologic or apremilast treatment. Most patients had improvement of their psoriasis. Discussion: The data reviewed here show successful treatment on biologics despite concurrent malignancy, though confirmatory research is needed. J Drugs Dermatol. 2019;18(4):387-390.
生物制剂已改变了中重度银屑病的治疗方式。治疗期间发生恶性肿瘤的风险是一个重要的考量因素，并且已经开展了许多研究来确定这一风险的程度。然而，对于有确诊恶性肿瘤病史的银屑病患者使用生物制剂治疗的研究却很少。方法：我们对有恶性肿瘤病史且接受生物制剂或阿普米拉斯治疗的银屑病患者进行了一项回顾性病历审查。列出了一份包含690例在2012年1月1日至2018年5月31日期间在我们诊所接受生物制剂或阿普米拉斯治疗的银屑病患者的名单。对病历进行了检查，发现16例患者有恶性肿瘤病史（不包括非黑色素瘤皮肤癌）。结果：16例患者符合纳入本综述的标准。从癌症诊断到开始使用生物制剂或阿普米拉斯的平均时间为4.7年，9例患者（56%）在5年内开始治疗。3例患者（19%）在生物制剂治疗期间接受了同步癌症治疗。在生物制剂或阿普米拉斯治疗期间，16例患者中无一例在临床或影像学上出现癌症复发或进展。大多数患者的银屑病有所改善。讨论：尽管存在并发恶性肿瘤，但此处审查的数据显示生物制剂治疗成功，不过仍需要进行验证性研究。《药物皮肤病学杂志》。2019年；18(4):387 - 390。
