Lin John Q, Li Shirley Q, Li Shufeng, Kiamanesh Eileen F, Aasi Sumaira Z, Kwong Bernice Y, Su Chang Anne Lynn
Department of Dermatology, Stanford University School of Medicine, Redwood City, California.
Baylor College of Medicine, Houston, Texas.
J Am Acad Dermatol. 2022 Feb;86(2):339-344. doi: 10.1016/j.jaad.2021.10.004. Epub 2021 Oct 11.
Clinical trials report occurrence of nonmelanoma skin cancers (NMSCs) with ruxolitinib in patients with polycythemia vera (PV) or myelofibrosis (MF); however, the level of risk and effect of covariates are not known in the real-world setting.
To systematically assess the risk of developing NMSC after ruxolitinib exposure in patients with PV or MF.
A 10-year retrospective cohort of patients with PV or MF at Stanford Medical Center was identified and matched according to age, gender, race, Charlson Comorbidity Index, disease diagnosis, and follow-up time. The main outcome measure was hazard ratio (HR) for NMSC (comprised of basal cell carcinoma and squamous cell carcinoma [SCC]) after ruxolitinib exposure, adjusted for covariates.
The study cohort consisted of 564 patients (188 exposed to ruxolitinib for at least 4 weeks, 376 unexposed). Ruxolitinib-exposed patients with PV or MF had an adjusted NMSC HR of 2.69 (95% CI, 1.03-7.02). In particular, ruxolitinib exposure was associated with SCC (HR, 3.24; 95% CI, 1.45-7.22), with non-Janus kinase 2-mutated patients showing even higher SCC risk (HR, 7.40; 95% CI, 2.54-21.63).
Retrospective design.
Our real-world results indicate that SCC risk is increased in patients with PV or MF taking ruxolitinib and support consideration of skin cancer monitoring.
临床试验报告了真性红细胞增多症（PV）或骨髓纤维化（MF）患者使用鲁索替尼后发生非黑色素瘤皮肤癌（NMSC）的情况；然而，在现实环境中，风险水平和协变量的影响尚不清楚。
系统评估PV或MF患者暴露于鲁索替尼后发生NMSC的风险。
在斯坦福医疗中心确定了一组10年的PV或MF患者回顾性队列，并根据年龄、性别、种族、查尔森合并症指数、疾病诊断和随访时间进行匹配。主要结局指标是暴露于鲁索替尼后NMSC（包括基底细胞癌和鳞状细胞癌[SCC]）的风险比（HR），并对协变量进行了调整。
研究队列包括564名患者（188名暴露于鲁索替尼至少4周，376名未暴露）。暴露于鲁索替尼的PV或MF患者经调整后的NMSC HR为2.69（95%CI，1.03-7.02）。特别是，鲁索替尼暴露与SCC相关（HR，3.24；95%CI，1.45-7.22），非Janus激酶2突变患者的SCC风险更高（HR，7.40；95%CI，2.54-21.63）。
回顾性设计。
我们的真实世界结果表明，服用鲁索替尼的PV或MF患者的SCC风险增加，并支持考虑进行皮肤癌监测。
