title: Risk of Incident Cancer in Inflammatory Bowel Disease Patients Starting Anti-TNF Therapy While Having Recent Malignancy.
abstract: Patients with inflammatory bowel disease (IBD) and history of malignancy within the last 5 years are usually contraindicated for receiving anti-tumor necrosis factor (anti-TNF) agents. The aim of this study is to assess survival without incident cancer in a cohort of IBD patients exposed to anti-TNF while having previous malignancy within past 5 years.
  
  
  
  Data from IBD patients with previous malignancy diagnosed within the last 5 years before starting an anti-TNF agent were collected through a Groupe d'Etude Thérapeutiques des Affections Inflammatoires du tube Digestif multicenter survey. Inclusion date corresponded to the first anti-TNF administration after cancer diagnosis.
  
  
  
  Twenty centers identified 79 cases of IBD patients with previous malignancy diagnosed 17 months (median; range: 1-65) before inclusion. The most frequent cancer locations were breast (n = 17) and skin (n = 15). After a median follow-up of 21 (range: 1-119) months, 15 (19%) patients developed incident cancer (8 recurrent and 7 new cancers), including 5 basal-cell carcinomas. Survival without incident cancer was 96%, 86%, and 66% at 1, 2, and 5 years, respectively. Crude incidence rate of cancer was 84.5 (95% CI, 83.1-85.8) per 1000 patient-years.
  
  
  
  In a population of refractory IBD patients with recent malignancy, anti-TNF could be used taking into account a mild risk of incident cancer. Pending prospective and larger studies, a case-by-case joint decision taken with the oncologist is recommended for managing these patients in daily practice.
authors.affiliation: 1CHU de Bordeaux, Hôpital Haut-Le[Combining Acute Accent]vêque, Service d'He[Combining Acute Accent]pato-gastroente[Combining Acute Accent]rologie, University of Bordeaux, Bordeaux, Pessac, France; 2Department of Gastroenterology, AP-HP, Hôpital Saint-Antoine, ERL 1157 INSERM/UMRS 7203, DHU 12B, UPMC, Paris, France; 3Department of Gastroenterology, Henri Mondor Hospital, Assistance Publique Hôpitaux de Paris, Paris Est Creteil University, Paris, France; 4CHRU de Lille, Hôpital Claude Huriez, Service des Maladies de l'Appareil Digestif-Endoscopie Digestive, Lille, France; 5Department of Gastroenterology, Cochin Hospital, Assistance Publique Hôpitaux de Paris and Paris V University, Paris, France; 6Hôpital Beaujon, Gastroente[Combining Acute Accent]rologie, Maladies Inflammatoires Chroniques de l'Intestin et Assistance Nutritive, AP-HP, Universite[Combining Acute Accent] Paris VII, Clichy, France; 7Department of Gastroenterology, CHU of Liège, University of Liège, Belgium; 8GIGA Research, University of Liege, Belgium; 9Service d'He[Combining Acute Accent]pato-Gastroente[Combining Acute Accent]rologie, CHU Amiens, Université de Picardie Jules Verne, Amiens, France; 10Department of Gastroenterology, Bichat Hospital, Assistance Publique Hôpitaux de Paris, Paris, France; 11Department of Gastroenterology, Lyon Sud Hospital, Hospices Civils de Lyon, Pierre Benite, France; 12INSERM U1111, CIRI, Lyon, France; 13INSERM U954 and Department of Hepato-Gastroenterology, University Hospital of Nancy, Université Henri Poincaré 1, Vandoeuvre-lès-Nancy, France; 14Inserm CIC 1114 and Institut des Maladies de l'Appareil Digestif, University Hospital, Nantes, France; 15CHU de Nice, Hôpital de l'Archet 2, Service de Gastroente[Combining Acute Accent]rologie et Nutrition Clinique, Nice, France; 16Department of Hepato-Gastroenterology and Digestive Oncology Hôpital Robert Debré, Reims, France; 17CHU de Rouen, Hôpital Charles Nicolle, Service de Gastroente[Combining Acute A
authors.forename: Florian
authors.initials: F
authors.lastname: Poullenot
authors.forename: Philippe
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authors.lastname: Seksik
authors.forename: Laurent
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authors.lastname: Beaugerie
authors.forename: Aurélien
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authors.lastname: Amiot
authors.forename: Maria
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authors.forename: Vered
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authors.lastname: Abitbol
authors.forename: Carmen
authors.initials: C
authors.lastname: Stefanescu
authors.forename: Catherine
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authors.lastname: Reenaers
authors.forename: Mathurin
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authors.lastname: Fumery
authors.forename: Anne-Laure
authors.initials: AL
authors.lastname: Pelletier
authors.forename: Stephane
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authors.lastname: Nancey
authors.forename: Laurent
authors.initials: L
authors.lastname: Peyrin-Biroulet
authors.forename: Arnaud
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authors.lastname: Bourreille
authors.forename: Xavier
authors.initials: X
authors.lastname: Hébuterne
authors.forename: Hedia
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authors.lastname: Brixi
authors.forename: Guillaume
authors.initials: G
authors.lastname: Savoye
authors.forename: Nelson
authors.initials: N
authors.lastname: Lourenço
authors.forename: Romain
authors.initials: R
authors.lastname: Altwegg
authors.forename: Anthony
authors.initials: A
authors.lastname: Buisson
authors.forename: Christine
authors.initials: C
authors.lastname: Cazelles-Boudier
authors.forename: Antoine
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authors.lastname: Racine
authors.forename: Julien
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authors.lastname: Vergniol
authors.forename: David
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authors.lastname: Laharie
mesh_terms: D000068879:Adalimumab / Q000627:therapeutic use*; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use*; D003093:Colitis, Ulcerative / Q000150:complications / Q000188:drug therapy*; D003424:Crohn Disease / Q000150:complications / Q000188:drug therapy*; D018572:Disease-Free Survival; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D000069285:Infliximab / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000453:epidemiology*; D009369:Neoplasms / Q000150:complications; D016609:Neoplasms, Second Primary / Q000453:epidemiology*; D015996:Survival Rate; D014409:Tumor Necrosis Factor-alpha / Q000037:antagonists & inhibitors; D055815:Young Adult
chemical_list: D000893:Anti-Inflammatory Agents; D014409:Tumor Necrosis Factor-alpha; D000069285:Infliximab; D000068879:Adalimumab