Massano Alessandro, Bertin Luisa, Zingone Fabiana, Buda Andrea, Visaggi Pierfrancesco, Bertani Lorenzo, de Bortoli Nicola, Fassan Matteo, Scarpa Marco, Ruffolo Cesare, Angriman Imerio, Bezzio Cristina, Casini Valentina, Ribaldone Davide Giuseppe, Savarino Edoardo Vincenzo, Barberio Brigida
Gastroenterology Unit, Department of Surgery, Oncology and Gastroenterology, University Hospital of Padova, 35128 Padova, Italy.
Gastroenterology Unit, Department of Gastrointestinal Oncological Surgery, S. Maria del Prato Hospital, 32032 Feltre, Italy.
Cancers (Basel). 2023 Jul 27;15(15):3824. doi: 10.3390/cancers15153824.
Inflammatory bowel disease (IBD) is a group of chronic multifactorial inflammatory disorders including two major entities: Crohn's disease (CD) and ulcerative colitis (UC). Preliminary evidence suggests that patients with IBD may be at increased risk of developing intestinal and extraintestinal cancers (EICs). Actually, little is known about the association between IBD and EICs, and there is ever-growing concern regarding the safety of immunomodulators and biological therapy, which may represent a risk factor for carcinogenesis.
The aim of this review is to summarize the evidence regarding the association between IBD and EICs, the safety of immunomodulators and biological therapy and the management of immunomodulators and biologic agents in IBD patients with prior or current EICs.
IBD patients have a higher risk of developing different forms of extraintestinal solid organ tumors and hematological malignancies. Immunomodulators and biological therapy may increase the risk of developing some types of EICs and may be consciously used in patients with IBD and current or prior history of malignancy.
Decisions regarding the use of immunomodulators or biological therapies should be made on an individual basis, considering a multidisciplinary approach involving oncologists.
炎症性肠病(IBD)是一组慢性多因素炎症性疾病,包括两个主要类型:克罗恩病(CD)和溃疡性结肠炎(UC)。初步证据表明,IBD患者发生肠道和肠外癌症(EIC)的风险可能增加。实际上,关于IBD与EIC之间的关联知之甚少,并且人们对免疫调节剂和生物疗法的安全性日益关注,这可能是致癌的一个危险因素。
本综述的目的是总结关于IBD与EIC之间关联、免疫调节剂和生物疗法的安全性以及在患有既往或当前EIC的IBD患者中免疫调节剂和生物制剂管理的证据。
IBD患者发生不同形式的肠外实体器官肿瘤和血液系统恶性肿瘤的风险更高。免疫调节剂和生物疗法可能会增加发生某些类型EIC的风险,并且在患有IBD以及有当前或既往恶性肿瘤病史的患者中可能会谨慎使用。
关于免疫调节剂或生物疗法的使用决策应基于个体情况做出,考虑采用包括肿瘤学家在内的多学科方法。