Safety of tumor necrosis factor inhibitor therapy in patients with a prior malignancy

Aim: 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. Conclusion: 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.