New or Recurrent Cancer Risk in IBD Patients With a Prior Malignancy Treated With TNF-antagonist or Vedolizumab

Researchers performed a retrospective analysis in a cohort of 463 patients with inflammatory bowel disease (IBD) and a history of malignancy. Patients remained on no immunosuppression (IS; n=183) or received anti-tumor necrosis factor (TNF) agents (infliximab, adalimumab, certolizumab pegol, golimumab; n=184) or vedolizumab (VDZ; n=96) after the cancer diagnosis. Slightly less than a third of the anti-TNF and VDZ recipients were also exposed to thiopurines or methotrexate. 

The median times after cancer diagnosis to initiation of anti-TNF agents or VDZ were 1.3 years (range, 0-38 years) and 3.9 years (0.1-43 years), respectively.  Among the anti-TNF group, 77 patients continued therapy without interruption at the time of cancer diagnosis. The median follow-up was 6.2 person-years, with solid tumors (50%) as the most common primary cancer. New or recurrent cancers were reported in 61 patients on anti-TNF therapy, 18 patients on VDZ, and 78 individuals in the no-IS cohort. Using a multivariable Cox model, no increased cancer risk was noted with anti-TNF agents (hazard ratio [HR], 1.03; 95% confidence interval [CI], 0.65-1.64) or VDZ (HR, 1.38; 95% CI, 0.38-1.36) compared to patients without IBD immunosuppressive medical therapy.

The authors concluded that neither vedolizumab nor anti-TNF agents were associated with an increased risk of new or recurrent cancers in patients with prior malignancy.