Available studies on patients with a prior or current cancer and exposure to immunosuppression
| Study (year) | Population | No of patients | Outcome | Conclusion |
|---|---|---|---|---|
| Prior cancer | ||||
| Penn (1993)5 | Renal transplant patients with prior cancer | 823 | Cancer recurrence | 22% with cancer recurrence |
| Dixon et al (2010)14 | RA patients with prior cancer exposed to anti-TNF | 177 Exposed 117 Unexposed | Rates of incident malignancy | No difference Incidence rate ratio 0.58 (95% CI 0.23 to 1.43) |
| Strangfeld et al (2010)15 | RA patients with prior cancer exposed to anti-TNF | 55 Exposed 58 Unexposed | Rates of incident malignancy | No difference Incidence rate ratio 1.4 (p=0.6) |
| Beaugerie et al (2012)13 | RA patients with prior cancer exposed to immunosuppression | 93 Exposed 312 Unexposed | Rates of incident malignancy | No difference New cancer (p=0.98) Recurrence cancer (p=0.26) |
| Current cancer | ||||
| Harrison et al (2007)32 | Phase II trial of IFX in current immunotherapy resistant or refractory renal cell carcinoma | 37 | Disease progression | IFX beneficial with median duration of response of 7.7 (low dose) and 6.2 (high dose) months |
| Brown et al (2008)33 | IFX in current advanced cancer | 41 | Primary: safety profile/biological response. Secondary: clinical response | No disease acceleration |
| Wiedenmann et al (2008)34 | Phase II trial of IFX in current pancreatic cancer | 89 | Primary: change in lean body mass. Secondary: surgical, progression free survival, Karnofksy performance status, 6 min walk test distance | Similar overall survival and progression free survival |
| Sogaard et al (2008)22 | IBD patients with breast cancer | 67 (CD) 216 (UC) | Breast cancer treatment. Survival | Survival lower in CD (p=0.037) |
| Jatoi et al (2010)35 | Randomised trial of IFX in current metastatic non-small cell lung cancer | 32 Exposed 29 Unexposed | Primary: >10% weight gain. Secondary: tumour response rate and overall survival | No difference Tumour response rate (p=0.048) Overall survival (p=0.88) |
| Raaschou et al (2011)23 | RA patients with cancer and prior exposure to anti-TNF | 314 586 Controls | Stage at diagnosis Risk of death | Stage: No difference Death: RR 1.1 (95% CI 0.8 to 1.6) |
| Sultan et al (2012)24 | IBD patients with lymphoma and prior exposure to thiopurine | 7 Exposed 7 Unexposed | Survival rates | No difference (p=0.95) |
| Axelrad et al (2012)40 | IBD with current extra-intestinal solid malignancy | 69 Inactive IBD 15 Active IBD | IBD outcomes (remission, time to disease activation) | Risk of flare with hormone therapy HR 11.04 (95% CI 1.22 to 99.85). Cytotoxic chemotherapy associated with IBD remission |
CD, Crohn's disease; IBD, inflammatory bowel disease; IFX, infliximab; RA, rheumatoid arthritis; TNF, tumour necrosis factor; UC, ulcerative colitis.