title: Safety of tumor necrosis factor inhibitor therapy in patients with a prior malignancy.
abstract: OBJECTIVE
  There is insufficient evidence to determine whether tumor necrosis factor inhibitor (TNFi) therapy is safe in patients with a recent history of cancer. The purpose of our study was to explore the influence of TNFi therapy on cancer-related outcomes in patients who had undergone curative cancer treatment.
  
  
  METHODS
  The medical records of 814 patients who received TNFi therapy at a single rheumatology clinic, between June 2005 and May 2014 were retrospectively reviewed. Among them, the data from patients having received anticancer treatment before starting TNFi therapy were collected and cancer-related outcomes were evaluated.
  
  
  RESULTS
  Twenty patients of 814 had a history of malignancy before initiating TNFi therapy. Over the duration of TNFi exposure (median, 54.0 months; interquartile range [IQR], 23.25-72.0 months), there was no recurrence of the previous cancer. In eight patients with early-stage cancer, TNFi therapy was initiated < 5 years after conclusion of previous anticancer treatments. Notably, over the duration of the ongoing treatment follow-up period (median, 33.5 months; IQR, 13.0-75.75 months), cancer recurrence was also not identified.
  
  
  CONCLUSIONS
  TNFi therapy in patients with a history of an early-stage localized cancer may not be contraindicated, even if TNFi is initiated < 5 years from completion of curative cancer treatment.
authors.affiliation: Division of Rheumatology, Department of Internal Medicine, GangNeung Asan Hospital, University of Ulsan College of Medicine, GangNeung, Korea.
authors.forename: Seung-Hyeon
authors.initials: SH
authors.lastname: Bae
authors.affiliation: Division of Rheumatology, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
authors.forename: Soo Min
authors.initials: SM
authors.lastname: Ahn
authors.affiliation: Division of Rheumatology, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
authors.forename: Doo-Ho
authors.initials: DH
authors.lastname: Lim
authors.affiliation: Division of Rheumatology, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
authors.forename: Seokchan
authors.initials: S
authors.lastname: Hong
authors.affiliation: Division of Rheumatology, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
authors.forename: Yong-Gil
authors.initials: YG
authors.lastname: Kim
authors.affiliation: Division of Rheumatology, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
authors.forename: Bin
authors.initials: B
authors.lastname: Yoo
authors.affiliation: Division of Rheumatology, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea. cklee@amc.seoul.kr.
authors.forename: Chang-Keun
authors.initials: CK
authors.lastname: Lee
mesh_terms: D000368:Aged; D018501:Antirheumatic Agents / Q000009:adverse effects / Q000627:therapeutic use*; D001688:Biological Products / Q000009:adverse effects / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D008297:Male; D008499:Medical Records; D008875:Middle Aged; D009367:Neoplasm Staging; D009369:Neoplasms / Q000453:epidemiology / Q000473:pathology / Q000628:therapy*; D056910:Republic of Korea / Q000453:epidemiology; D012189:Retrospective Studies; D012216:Rheumatic Diseases / Q000175:diagnosis / Q000453:epidemiology / Q000276:immunology / Q000628:therapy*; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome; D014409:Tumor Necrosis Factor-alpha / Q000037:antagonists & inhibitors* / Q000276:immunology
chemical_list: D018501:Antirheumatic Agents; D001688:Biological Products; D014409:Tumor Necrosis Factor-alpha
keywords: cancer; inhibitor; rheumatic disease; safety; tumor necrosis factor