University of Texas Southwestern Medical School, Dallas, TX, USA.
Department of Dermatology, University of Texas Southwestern Medical Center, 5939 Harry Hines Boulevard, Suite 400, Dallas, Texas, 75390, USA.
Curr Treat Options Oncol. 2021 Jan 9;22(2):11. doi: 10.1007/s11864-020-00815-y.
JAK (janus kinase) inhibitors are becoming increasingly prescribed for various conditions from dermatologic diseases to graft versus host disease in bone marrow transplant recipients. This class of drugs has been found to be truly life-changing for many, though they are not without potential adverse effects. While JAK inhibitors have not been shown to significantly increase the risk of non-melanoma skin cancer (NMSC) in large scale clinical trials, NMSC is one of the most concerning possible adverse events, and there have been several reported cases of aggressive squamous cell carcinomas, especially in our already immunosuppressed patient populations. In these patients, it is incredibly important that patients are on the lowest possible dosage of the JAK inhibitor. In addition, these patients must be routinely screened by a dermatologist with a comprehensive skin exam to ensure early detection if skin cancer was to develop. For those patients diagnosed with skin cancer, early intervention is key to optimize outcomes, and at times, multi-disciplinary care coordination is needed. In the future, large-scale studies with longer follow-up of patients would help determine whether JAK inhibitors significantly increase the risk of NMSC.
JAK（Janus kinase）抑制剂正被越来越多地用于治疗各种疾病，从皮肤科疾病到骨髓移植受者的移植物抗宿主病。虽然这类药物对许多人来说确实具有改变生活的效果，但它们并非没有潜在的不良反应。虽然大型临床试验并未表明 JAK 抑制剂会显著增加非黑色素瘤皮肤癌（NMSC）的风险，但 NMSC 是最令人担忧的可能不良事件之一，已经有几例侵袭性鳞状细胞癌的报告，尤其是在我们已经免疫抑制的患者群体中。对于这些患者，让他们使用最低剂量的 JAK 抑制剂非常重要。此外，这些患者必须由皮肤科医生进行全面的皮肤检查，以确保及早发现皮肤癌。对于那些被诊断患有皮肤癌的患者，早期干预是优化治疗结果的关键，有时需要多学科的护理协调。未来，对患者进行更长时间随访的大规模研究将有助于确定 JAK 抑制剂是否会显著增加 NMSC 的风险。
