Download PDF
Aktuelle Rheumatologie 2020; 45(06): 523-530
DOI: 10.1055/a-1247-4252
Übersichtsarbeit

Rheumatologische medikamentöse Therapie bei Malignomanamnese

Rheumatological Drug Treatment in Patients with a History of Malignancy
Marc Schmalzing
1   Rheumatologie / Klinische Immunologie, Medizinische Klinik und Poliklinik II, Universitätsklinikum Würzburg, Würzburg
› Author Affiliations
› Further Information
Also available at
   Permissions and Reprints

Zusammenfassung

Rheumatologische Therapie bei Patienten mit Malignomanamnese ist mit komplexen Fragestellungen verbunden. Schwierigkeiten und Lösungsmöglichkeiten bei der Interpretation aussagekräftiger Studien werden dargestellt. Empfehlungen in Leitlinien zu diesem Thema werden diskutiert. Nationale Register und Versicherungsdatenbanken wurden mit der Frage nach Tumorrezidivrisiko unter Basistherapeutika untersucht ; diese Analysen beziehen sich aber v. a. auf TNF-Inhibitoren und Rituximab. Zu den gängigen Substanzen der Basistherapie werden Daten zur Tumorinzidenz und wenn vorhanden zum Tumorrezidivrisiko zusammengefasst. Abschließend wird der Versuch unternommen Vorschläge zur rheumatolgischen Therapie bei Malignomanamnese zu formulieren.

Abstract

Rheumatological therapy in patients with a history of malignancy is associated with complex questions. Difficulties and possible solutions in the interpretation of meaningful studies are presented. Recommendations in guidelines on this topic are discussed. National registries and insurance databases have been examined as to the tumour recurrence risk under disease-modifying antirheumatic drugs; however, these analyses mainly refer to TNF inhibitors and rituximab. Data on tumor incidence and, if available, tumor recurrence risk are summarized for common disease-modifying antirheumatic drugs. Finally, an attempt is made to formulate proposals for rheumatological therapy in patients with a history of malignancy.

Schlüsselwörter

Basistherapie - Malignom - Immunsuppression

Key words

DMARD - malignancy - immunosuppression


Publication History

Article published online:
21 October 2020

© 2020. Thieme. All rights reserved.

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany

 

  • Literatur

  • 1 Baecklund E, Iliadou A, Askling J. et al. Association of chronic inflammation, not its treatment, with increased lymphoma risk in rheumatoid arthritis. Arthritis Rheum 2006; 54: 692-701
    CrossrefPubMedGoogle Scholar
  • 2 Zhang Y, Sun Y, Zhang Q. Prognostic value of the systemic immune-inflammation index in patients with breast cancer: a meta-analysis. Cancer Cell Int 2020; 20: 224
    CrossrefPubMedGoogle Scholar
  • 3 Hirano T, Hirayama D, Wagatsuma K. et al. Immunological Mechanisms in Inflammation-Associated Colon Carcinogenesis. Int J Mol Sci 2020; 21: 3062
    CrossrefPubMedGoogle Scholar
  • 4 Moik F, Zöchbauer-Müller S, Posch F. et al. Systemic Inflammation and Activation of Haemostasis Predict Poor Prognosis and Response to Chemotherapy in Patients with Advanced Lung Cancer. Cancers (Basel) 2020; 12: E1619
    CrossrefPubMedGoogle Scholar
  • 5 Kampan NC, Madondo MT, McNally OM. et al. Interleukin 6 Present in Inflammatory Ascites from Advanced Epithelial Ovarian Cancer Patients Promotes Tumor Necrosis Factor Receptor 2-Expressing Regulatory T Cells. Front Immunol 2017; 8: 1482
    CrossrefPubMedGoogle Scholar
  • 6 Krathen MS, Gottlieb AB, Mease PJ. Pharmacologic immunomodulation and cutaneous malignancy in rheumatoid arthritis, psoriasis, and psoriatic arthritis. J Rheumatol 2010; 37: 2205-2215
    CrossrefPubMedGoogle Scholar
  • 7 Mercer LK, Davies R, Galloway JB. et al. Risk of cancer in patients receiving non-biologic disease-modifying therapy for rheumatoid arthritis compared with the UK general population. Rheumatology 2013; 52: 9198
    CrossrefPubMedGoogle Scholar
  • 8 Nocturne G, Mariette X. Sjögren Syndrome-associated lymphomas: an update on pathogenesis and management. Br J Haematol 2015; 168: 317-327
    CrossrefPubMedGoogle Scholar
  • 9 Feldman CH, Liu J, Feldman S. et al. Risk of high-grade cervical dysplasia and cervical cancer in women with systemic lupus erythematosus receiving immunosuppressive drugs. Lupus 2017; 26: 682-689
    CrossrefPubMedGoogle Scholar
  • 10 Lopez-Olivo MA, Colmegna I, Karpes Matusevich AR. et al. Systematic Review of Recommendations on the Use of Disease-Modifying Antirheumatic Drugs in Patients With Rheumatoid Arthritis and Cancer. Arthritis Care Res (Hoboken) 2020; 72: 309-318
    CrossrefPubMedGoogle Scholar
  • 11 Singh JA, Furst DE, Bharat A. et al. 2012 update of the 2008 American College of Rheumatology recommendations for the use of disease-modifying antirheumatic drugs and biologic agents in the treatment of rheumatoid arthritis. Arthritis Care Res (Hoboken) 2012; 64: 625-639
    CrossrefPubMedGoogle Scholar
  • 12 Singh JA, Saag KG, Bridges SL. et al. 2015 American College of Rheumatology Guideline for the Treatment of Rheumatoid Arthritis. Arthritis Care Res (Hoboken) 2016; 68: 1-25
    CrossrefPubMedGoogle Scholar
  • 13 Penn I. Evaluation of transplant candidates with pre-existing malignancies. Ann Transplant 1997; 2: 14-17
    PubMedGoogle Scholar
  • 14 Tarella C, Passera R, Magni M. et al. Risk factors for the development of secondary malignancy after high-dose chemotherapy and autograft, with or without rituximab: a 20-year retrospective follow-up study in patients with lymphoma. J Clin Oncol 2011; 29: 814-824
    CrossrefPubMedGoogle Scholar
  • 15 Strangfeld A, Hierse F, Rau R. et al. Risk of incident or recurrent malignancies among patients with rheumatoid arthritis exposed to biologic therapy in the German biologics register RABBIT. Arthritis Res Ther 2010; 12: R5
    CrossrefPubMedGoogle Scholar
  • 16 Dixon WG, Watson KD, Lunt M. et al. Influence of antitumor necrosis factor therapy on cancer incidence in patients with rheumatoid arthritis who have had a prior malignancy: results from the British Society for Rheumatology Biologics Register. Arthritis Care Res 2010; 62: 755-763
    CrossrefPubMedGoogle Scholar
  • 17 Pappas DA, Rebello S, Liu M. et al. Therapy with Biologic Agents After Diagnosis of Solid Malignancies: Results from the Corrona Registry. J Rheumatol 2019; 46: 1438-1444
    CrossrefPubMedGoogle Scholar
  • 18 Dreyer L, Cordtz RL, Hansen IMJ. et al. Risk of second malignant neoplasm and mortality in patients with rheumatoid arthritis treated with biological DMARDs: a Danish population-based cohort study. Ann Rheum Dis 2018; 77: 510-514
    CrossrefPubMedGoogle Scholar
  • 19 Raaschou P, Sö derling J, Turesson C. et al. ARTIS Study Group. Tumor necrosis factor inhibitors and cancer recurrence in Swedish patients with rheumatoid arthritis: a nationwide population-based cohort study. Ann Intern Med 2018; 169: 291-299
    CrossrefPubMedGoogle Scholar
  • 20 Xie W, Xiao S, Huang Y. et al. A meta-analysis of biologic therapies on risk of new or recurrent cancer in patients with rheumatoid arthritis and a prior malignancy. Rheumatology (Oxford). 2019; Oct 17. [Epub ahead of print]
    PubMed
  • 21 Shelton E, Laharie D, Scott FI. et al. Cancer Recurrence Following Immune-Suppressive Therapies in Patients With Immune-Mediated Diseases: A Systematic Review and Meta-analysis. Gastroenterology 2016; 151: 97-109.e4
    CrossrefPubMedGoogle Scholar
  • 22 Mamtani R, Clark AS, Scott FI. et al. Association between breast cancer recurrence and immunosuppression in rheumatoid arthritis and inflammatory bowel disease: a cohort study. Arthritis Rheumatol 2016; 68: 2403_11
    CrossrefPubMedGoogle Scholar
  • 23 Mercer LK, Lunt M, Low AL. et al. Risk of solid cancer in patients exposed to anti-tumour necrosis factor therapy: results from the British Society for Rheumatology Biologics Register for Rheumatoid Arthritis. Ann Rheum Dis 2015; 74: 1087-1093
    CrossrefPubMedGoogle Scholar
  • 24 Schmalzing M, Strangfeld A, Tony HP. Medikamentöse Therapie der rheumatoiden Arthritis bei Malignomanamnese. Epidemiologische Daten [Medication treatment of rheumatoid arthritis with a history of malignancy. Epidemiological data]. Z Rheumatol 2016; 75: 22-31
    CrossrefPubMedGoogle Scholar
  • 25 Regierer AC, Strangfeld A. Rheumatoid arthritis treatment in patients with a history of cancer. Curr Opin Rheumatol 2018; 30: 288-294
    CrossrefPubMedGoogle Scholar
  • 26 Shelton E, Laharie D, Scott FI. et al. Cancer Recurrence Following Immune-Suppressive Therapies in Patients With Immune-Mediated Diseases: A Systematic Review and Meta-analysis. Gastroenterology. 2016; 151: 97-109.e4
    CrossrefPubMedGoogle Scholar
  • 27 De Cock D, Hyrich K. Malignancy and rheumatoid arthritis: Epidemiology, risk factors and management. Best Pract Res Clin Rheumatol 2018; 32: 869-886
    CrossrefPubMedGoogle Scholar
  • 28 Lange E, Blizzard L, Venn A. et al. Disease-modifying anti-rheumatic drugs and non-melanoma skin cancer in inflammatory arthritis patients: a retrospective cohort study. Rheumatology (Oxford) 2016; 55: 1594-1600
    CrossrefPubMedGoogle Scholar
  • 29 Solomon DH, Glynn RJ, Karlson EW. et al. Adverse Effects of Low-Dose Methotrexate: A Randomized Trial. Ann Intern Med. 2020; Feb 18. [Epub ahead of print]
    PubMed
  • 30 Rizzi R, Curci P, Delia M. et al. Spontaneous remission of “methotrexate-associated lymphoproliferative disorders” after discontinuation of immunosuppressive treatment for autoimmune disease. Review of the literature. Med Oncol 2009; 26: 1-9
    CrossrefPubMedGoogle Scholar
  • 31 Hellgren K, Baecklund E, Backlin C. et al. Rheumatoid Arthritis and Risk of Malignant Lymphoma: Is the Risk Still Increased?. Arthritis Rheumatol 2017; 69: 700-708
    CrossrefPubMedGoogle Scholar
  • 32 Behrens F, Koehm M, Burkhardt H. Update 2011: leflunomide in rheumatoid arthritis – strengths and weaknesses. Curr Opin Rheumatol 2011; 23: 282-287
    CrossrefPubMedGoogle Scholar
  • 33 Ruiz-Irastorza G, Ugarte A, Egurbide MV. et al. Antimalarials may influence the risk of malignancy in systemic lupus erythematosus. Ann Rheum Dis 2007; 66: 815-817
    CrossrefPubMedGoogle Scholar
  • 34 Fardet L, Nazareth I, Petersen I. Effects of chronic exposure of hydroxychloroquine/chloroquine on the risk of cancer, metastasis, and death: a population-based cohort study on patients with connective tissue diseases. Clin Epidemiol 2017; 9: 545-554
    CrossrefPubMedGoogle Scholar
  • 35 Lopez A, Pouillon L, Beaugerie L. et al. Colorectal cancer prevention in patients with ulcerative colitis. Best Pract Res Clin Gastroenterol 2018; 32-33: 103-109
    CrossrefPubMedGoogle Scholar
  • 36 T. J. Moore Safety perspectives: cancer risks of biological products for psoriasis. https://www.ismp.org/quarterwatch/safety-perspectives (accessed: March 29, 2018)
    PubMed
  • 37 Thai A, Prindiville T. Hepatosplenic T-cell lymphoma and inflammatory bowel disease. J Crohns Colitis 2010; 4: 511-22
    CrossrefPubMedGoogle Scholar
  • 38 Ertz-Archambault N, Kosiorek H, Taylor GE. et al. Association of Therapy for Autoimmune Disease With Myelodysplastic Syndromes and Acute Myeloid Leukemia. JAMA Oncol 2017; 3: 936-943
    CrossrefPubMedGoogle Scholar
  • 39 Scott FI, Mamtani R, Brensinger CM. et al. Risk of Nonmelanoma Skin Cancer Associated With the Use of Immunosuppressant and Biologic Agents in Patients With a History of Autoimmune Disease and Nonmelanoma Skin Cancer. JAMA Dermatol 2016; 152: 164-172
    CrossrefPubMedGoogle Scholar
  • 40 Muellenhoff MW, Koo JY. Cyclosporine and skin cancer: an international dermatologic perspective over 25 years of experience. A comprehensive review and pursuit to define safe use of cyclosporine in dermatology. J Dermatolog Treat 2012; 23: 290-304
    CrossrefPubMedGoogle Scholar
  • 41 Vos M, Plasmeijer EI, van Bemmel BC. et al. Azathioprine to mycophenolate mofetil transition and risk of squamous cell carcinoma after lung transplantation. J Heart Lung Transplant 2018; 37: 853-859
    CrossrefPubMedGoogle Scholar
  • 42 Hellbacher E, Hjorton K, Backlin C. et al. Malignant lymphoma in granulomatosis with polyangiitis: subtypes, clinical characteristics and prognosis. Acta Oncol 2019; 58: 1655-1659
    CrossrefPubMedGoogle Scholar
  • 43 Kang KY, Kim HO, Yoon HS. et al. Incidence of cancer among female patients with systemic lupus erythematosus in Korea. Clin Rheumatol 2010; 29: 381-388
    CrossrefPubMedGoogle Scholar
  • 44 Raaschou P, Simard JF, Asker Hagelberg C. et al. ARTIS Study Group Rheumatoid arthritis, anti-tumour necrosis factor treatment, and risk of squamous cell and basal cell skin cancer: cohort study based on nationwide prospectively recorded data from Sweden. BMJ. 2016; 352: i262
    PubMedGoogle Scholar
  • 45 Mercer LK, Askling J, Raaschou P. et al. Risk of invasive melanoma in patients with rheumatoid arthritis treated with biologics: results from a collaborative project of 11 European biologic registers. Ann Rheum Dis 2017; 76: 386-391
    CrossrefPubMedGoogle Scholar
  • 46 Staples MP, March L, Hill C. et al. Malignancy risk in Australian rheumatoid arthritis patients treated with anti-tumour necrosis factor therapy: an update from the Australian Rheumatology Association Database (ARAD)prospective cohort study. BMC Rheumatol 2019; 3: 1
    CrossrefPubMedGoogle Scholar
  • 47 Cordtz R, Mellemkjær L, Glintborg B. et al. Malignant progression of precancerous lesions of the uterine cervix following biological DMARD therapy in patients with arthritis. Ann Rheum Dis 2015; 74: 1479-80
    CrossrefPubMedGoogle Scholar
  • 48 Calip GS, Patel PR, Adimadhyam S. et al. Tumor necrosis factor-alpha inhibitors and risk of non-Hodgkin lymphoma in a cohort of adults with rheumatologic conditions. Int J Cancer 2018; 143: 1062-1071
    CrossrefPubMedGoogle Scholar
  • 49 Mercer LK, Galloway JB, Lunt M. et al. Risk of lymphoma in patients exposed to antitumour necrosis factor therapy: results from the British Society for Rheumatology Biologics Register for Rheumatoid Arthritis. Ann Rheum Dis 2017; 76: 497-503
    CrossrefPubMedGoogle Scholar
  • 50 Perez-Ruiz E, Minute L, Otano I. et al. Prophylactic TNF blockade uncouples efficacy and toxicity in dual CTLA-4 and PD-1 immunotherapy. Nature 2019; 569: 428-432
    CrossrefPubMedGoogle Scholar
  • 51 Bertrand F, Montfort A, Marcheteau E. et al. TNFα blockade overcomes resistance to anti-PD-1 in experimental melanoma. Nat Commun 2017; 8: 2256
    CrossrefPubMedGoogle Scholar
  • 52 Badran YR, Cohen JV, Brastianos PK. et al. Concurrent therapy with immune checkpoint inhibitors and TNFα blockade in patients with gastrointestinal immune-related adverse events. J Immunother Cancer 2019; 7: 226
    CrossrefPubMedGoogle Scholar
  • 53 Kim ST, Tayar J, Trinh VA. et al. Successful treatment of arthritis induced by checkpoint inhibitors with tocilizumab: a case series. Ann Rheum Dis 2017; 76: 2061-2064
    CrossrefPubMedGoogle Scholar
  • 54 Kim SC, Pawar A, Desai RJ. et al. Risk of malignancy associated with use of tocilizumab versus other biologics in patients with rheumatoid arthritis: A multi-database cohort study. Semin Arthritis Rheum 2019; 49: 222-228
    CrossrefPubMedGoogle Scholar
  • 55 Wadström H, Frisell T, Askling J. Anti-Rheumatic Therapy in Sweden (ARTIS)Study Group. Malignant Neoplasms in Patients With Rheumatoid Arthritis Treated With Tumor Necrosis Factor Inhibitors, Tocilizumab, Abatacept, or Rituximab in Clinical Practice: A Nationwide Cohort Study From Sweden. JAMA Intern Med 2017; 177: 1605-1612
    CrossrefPubMedGoogle Scholar
  • 56 Montastruc F, Renoux C, Dell'Aniello S. et al. Abatacept initiation in rheumatoid arthritis and the risk of cancer: a population-based comparative cohort study. Rheumatology (Oxford) 2019; 58: 683-691
    CrossrefPubMedGoogle Scholar
  • 57 de Germay S, Bagheri H, Despas F. et al. Abatacept in rheumatoid arthritis and the risk of cancer: a world observational post-marketing study. Rheumatology (Oxford). 2019; Dec 27, [Epub ahead of print]
    PubMed
  • 58 Nast A, Amelunxen L. Augustin. et al. S3 – Leitlinie zur Therapie der Psoriasis vulgaris Update. 2017; AWMF-Register Nr. 013/001
    PubMed
  • 59 Fiorentino D, Ho V, Lebwohl MG. et al. Risk of malignancy with systemic psoriasis treatment in the Psoriasis Longitudinal Assessment Registry. J Am Acad Dermatol 2017; 77: 845-854.e5
    CrossrefPubMedGoogle Scholar
  • 60 Ridker PM, MacFadyen JG, Thuren T. et al. CANTOS Trial Group Effect of interleukin-1β inhibition with canakinumab on incident lung cancer in patients with atherosclerosis: exploratory results from a randomised, double-blind, placebo-controlled trial. Lancet 2017; 390: 1833-1842
    CrossrefPubMedGoogle Scholar
  • 61 Porpaczy E, Tripolt S, Hoelbl-Kovacic A. et al. Aggressive B-cell lymphomas in patients with myelofibrosis receiving JAK1/2 inhibitor therapy. Blood 2018; 132: 694-706
    CrossrefPubMedGoogle Scholar
  • 62 Pemmaraju N, Kantarjian H, Nastoupil L. et al. Characteristics of patients with myeloproliferative neoplasms with lymphoma, with or without JAK inhibitor therapy. Blood 2019; 133: 2348-2351
    CrossrefPubMedGoogle Scholar
  • 63 Integrated safety summary, Abbvie data on file
    PubMed
  • 64 Smolen JS, Genovese MC, Takeuchi T. et al. Safety Profile of Baricitinib in Patients with Active Rheumatoid Arthritis with over 2 Years Median Time in Treatment. J Rheumatol 2019; 46: 7-18
    CrossrefPubMedGoogle Scholar
  • 65 Kremer J, Bingham C, Cappelli L. et al. Comparison of Malignancy and Mortality Rates Between Tofacitinib and Biologic DMARDs in Clinical Practice: Five-Year Results from a US-Based Rheumatoid Arthritis Registry [abstract]. Arthritis Rheumatol 2019; 71: (suppl 10) https://acrabstracts.org/abstract/comparison-of-malignancy-and-mortality-rates-between-tofacitinib-and-biologic-dmards-in-clinical-practice-five-year-results-from-a-us-based-rheumatoid-arthritis-registry/. Accessed October 6, 2020.
    PubMed