Vangilbergen Marie, Stockman Aline, Van De Velde Axelle, Garmyn Maria, Punie Kevin, Hillary Tom
Department of Dermatology, University Hospitals Leuven, Leuven, Belgium.
Research Group of Dermatology, University of KULeuven, Leuven, Belgium.
JAAD Int. 2024 Aug 16;17:71-79. doi: 10.1016/j.jdin.2024.06.006. eCollection 2024 Dec.
Biologicals targeting interleukin (IL)-17 and IL-23 improve quality of life in psoriasis and other chronic autoimmune disorders with a favorable safety profile. However, current guidelines do not recommend their use in patients with recent oncologic history due to limited evidence.
To understand the impact of IL-17 and IL-23 inhibitors on cancer development, progression, and recurrence by systematically reviewing available literature.
We conducted a systematic review following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines.
Most studies investigating the use of IL-23 and IL-17 blockers did not find a higher incidence of cancer compared to the general population. One study observed no relapse in patients with a history of cancer.
The systematic review is limited due to variations in study designs and outcomes, making it difficult to achieve a comprehensive synthesis and comparison between studies. Furthermore, small sample sizes were notable.
Preclinical studies suggest that treating psoriasis with IL-17 or IL-23 blockers is safe, also in patients witch active cancer or a history of it. Pharmacovigilance data show no increased malignancy rate in patients treated with these treatment modalities. However, data on relapse in patients with a history or active malignancy are limited.
靶向白细胞介素(IL)-17和IL-23的生物制剂可改善银屑病及其他慢性自身免疫性疾病患者的生活质量,且安全性良好。然而,由于证据有限,目前的指南不建议在有近期肿瘤病史的患者中使用这些生物制剂。
通过系统回顾现有文献,了解IL-17和IL-23抑制剂对癌症发生、发展和复发的影响。
我们按照系统评价和Meta分析的首选报告项目指南进行了系统评价。
与普通人群相比,大多数研究IL-23和IL-17阻滞剂使用情况的研究未发现癌症发病率更高。一项研究观察到有癌症病史的患者无复发情况。
由于研究设计和结果的差异,该系统评价存在局限性,难以对各研究进行全面的综合和比较。此外,样本量较小也是显著问题。
临床前研究表明,使用IL-17或IL-23阻滞剂治疗银屑病是安全的,对于有活动性癌症或癌症病史的患者也是如此。药物警戒数据显示,接受这些治疗方式的患者恶性肿瘤发生率并未增加。然而,关于有癌症病史或活动性恶性肿瘤患者复发情况的数据有限。