Biológicos y cáncer: ¿una relación peligrosa?

M. Chaparro , J.P. Gisbert
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Abstract

Anti-TNF agents have shown to be effective treating immuno-mediated diseases. The first cases of lymphoma diagnosed after the approval of anti-TNF focused their attention on the role of these drugs in the risk of tumor development. In patients with inflammatory bowel disease and other immune-mediated diseases, especially rheumatoid arthritis, anti-TNF drugs do not appear to increase the risk of developing malignancies. Conflicting results were only observed in the case of risk of lymphoma and skin cancer. However, if the treatment with anti-TNF drugs increases the risk of development of these tumors, the magnitude of effect and the absolute number of cases would be very low, so that the benefit of these treatments clearly exceeds the potential risks. Finally, the effect of anti-TNF in patients with a history of neoplasia is poorly known; current evidence suggests there is no increased risk of tumor recurrence in patients exposed to these drugs. However, because data about this issue are scarce, it would be prudent to assess each case individually, taking into account the history of cancer and the available alternatives for the control of inflammatory bowel disease.

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生物学和癌症:危险的关系?
抗肿瘤坏死因子已被证明是有效的治疗免疫介导的疾病。抗肿瘤坏死因子获批后诊断出的第一例淋巴瘤患者将注意力集中在这些药物在肿瘤发展风险中的作用上。在炎症性肠病和其他免疫介导性疾病,特别是类风湿性关节炎患者中,抗肿瘤坏死因子药物似乎不会增加发生恶性肿瘤的风险。矛盾的结果仅在淋巴瘤和皮肤癌风险的情况下观察到。然而,如果使用抗肿瘤坏死因子药物治疗会增加这些肿瘤发展的风险,其作用的大小和病例的绝对数量将非常低,因此这些治疗的益处显然超过了潜在的风险。最后,抗肿瘤坏死因子在有肿瘤病史的患者中的作用尚不清楚;目前的证据表明,暴露于这些药物的患者肿瘤复发的风险没有增加。然而,由于关于这一问题的数据很少,考虑到癌症病史和控制炎症性肠病的可用替代方案,对每个病例进行单独评估将是谨慎的。
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