Author Topic: Connection between DMTs and cancer-risk in MS patients?  (Read 140 times)

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Offline agate

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Connection between DMTs and cancer-risk in MS patients?
« on: June 30, 2015, 05:08:53 pm »
From the MSFYi newsletter (MS Foundation), July 1, 2015:

Quote

Researchers say treatment increases cancer risk in MS patients

A new study finds that while multiple sclerosis patients do not seem to have a greater risk of cancer than the general population, the use of immunosuppressors does increase the risk. Researchers also found that the increase of kidney cancer risk in male patients deserves greater scrutiny.

 

Scientists in France wanted to measure the cancer risk in MS patients and the cancer risk of immunomodulators and immunosuppressors. They found that cancer risk was not increased in comparison to the general population. In women, breast cancer was reduced. However, kidney cancer was increased in men. The increased cancer risk was linked to an old age at MS diagnosis and exposure to immunosuppressors. When the entire population of MS patients was considered, patients with a history of immunosuppression therapy had an increased risk of cancer.

 

The study was drawn from a group of 1581 MS patients in France. The final group of 66 MS patients was diagnosed at an average of 42 years old, and diagnosed with cancer at an average age of 54. The most frequent cancers found were breast (33 percent), digestive (11 percent), kidney (8 percent), skin (8 percent), prostate (6 percent) central nervous system (5 percent), and bladder (5 percent).

 

The results were presented at the American Academy of Neurology's annual meeting.


Here is the abstract of the presentation at the AAN in April 2015:

Quote
[P1.102] Cancer Risk associated with Disease-Modifying Drugs in Multiple Sclerosis: a French Registry-based Study

Mathilde Lefilliatre, Nathalie Derache, Elodie Guillaume, Karine Droulon, Guy Launoy, Gilles Defer
Caen, France.

OBJECTIVE: To evaluate cancer risk in Multiple Sclerosis (MS) patients in Lower Normandy (LN) area, France.

BACKGROUND: Before disease-modifying drugs use, MS was considered to have reduced rates of cancer. Use of immunosuppressors (IS) and immunomodulators (IM) justifies an evaluation of cancer risk in MS patients over years.

DESIGN/METHODS: Cancer cases and their location were identified among 1581 MS patients included in the LN MS registry from 2003 to 2011. We cross-referenced the data of 3 population-based regional cancer registries, to assess the occurrence of cancer in our MS patients and to compare their cancer risk to the general population. Standardized incidence ratios (SIR) were used to measure the relative risk of cancer in our MS population. The impact of IM or IS exposure on the cancer risk was also evaluated.

RESULTS: Sixty-six MS patients (4,2%) developed a cancer : mean age at MS diagnosis of 42,7 years and at cancer diagnosis of 54,2 years. The most frequent observed cancers were breast (33,3%), digestive (10,6%), kidney (7,6%), skin (7,6%), prostate
(6,1%), central nervous system (4,6%) and bladder (4,6%). SIR were 0,96 (0,74-1,22) for men and 0,96 (0,70-1,29) for women. Cancer risk in this MS population was not increased in comparison to the general population. Breast cancer risk was decreased in women (SIR=0,52 ; (0,26-0,93)) and kidney cancer risk was increased in men (SIR=5,33 ; (1,43-13,65)). Increased risk of cancer was associated with an old age at MS diagnosis and exposure to IS in multivariate analysis. When considering the whole cohort, patients with a history of IS had a 2,3-fold higher
risk of developing cancer (p=0,03).

CONCLUSIONS: MS patients do not seem to have an increased risk of cancer but IS exposure increases this risk. The increase of the kidney cancer risk in men warrant confirmation.

Category - Neuroepidemiology: MS and CNS Inflammatory Disease

Session: P1: Poster Session I: Neuroepidemiology: MS and CNS Inflammatory Disease (2:00 PM-6:30 PM)
Date/Time: Monday, April 20, 2015 - 2:00 pm

It isn't clear whether the researchers are equating immunosuppression with immunomodulation here.
« Last Edit: October 25, 2016, 09:10:07 am by agate »
MS Speaks--online for 13 years

SPMS, diagnosed 1980. Avonex 2001-2004. Copaxone 2007-2010.

Offline agate

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More on this topic--from PubMed, October 25, 2016:

Quote
J Neurol Sci. 2016 Nov 15;370:13-17.

Decreased risk of cancer in multiple sclerosis patients and analysis of the effect of disease modifying therapies on cancer risk.

Gaindh D1, Kavak KS2, Teter B3, Vaughn CB3, Cookfair D4, Hahn T5, Weinstock-Guttman B6; New York State Multiple Sclerosis Consortium.

Author information


1Jacobs Comprehensive MS Treatment and Research Center, University at Buffalo, Buffalo, NY, USA.
2Jacobs Comprehensive MS Treatment and Research Center, University at Buffalo, Buffalo, NY, USA; New York State MS Consortium, University at Buffalo, Buffalo, NY, USA.
3Jacobs Comprehensive MS Treatment and Research Center, University at Buffalo, Buffalo, NY, USA; New York State MS Consortium, University at Buffalo, Buffalo, NY, USA; Department of Neurology, State University of New York at Buffalo, Buffalo, NY, USA.
4Department of Neurology, State University of New York at Buffalo, Buffalo, NY, USA.
5Department of Medicine, Roswell Park Cancer Institute, Buffalo, NY, USA.
6Jacobs Comprehensive MS Treatment and Research Center, University at Buffalo, Buffalo, NY, USA; New York State MS Consortium, University at Buffalo, Buffalo, NY, USA; Department of Neurology, State University of New York at Buffalo, Buffalo, NY, USA. Electronic address: bweinstock-guttman@kaleidahealth.org.

BACKGROUND:

Although dysimmunity is considered an important link between multiple sclerosis (MS), family history and cancer risk, their relationship to the use of disease modifying therapies (DMT) is not fully understood.

OBJECTIVE:

To assess the observed versus expected number of cancers in MS patients, and family history of cancer, among DMT users and DMT-na´ve patients.

METHODS:

Cancer, DMT use, and family history of cancer were assessed using the New York State Multiple Sclerosis Consortium (NYSMSC) registry. Self-reported cancers in MS patients were tested for associations with DMT use, family history of cancer and other factors. Expected number of cancer cases was estimated using age- and gender-specific prevalence and incidence rates from the general population.

RESULTS:

The prevalence of cancer in males and females in the NYSMSC cohort was lower than expected (p<0.001). Patients with cancer were older at MS diagnosis and more likely to be female (p<0.001). MS patients with a personal history of cancer were more likely to report DMT use (p<0.001) and family history of cancer (p<0.001). Multivariable analysis did not support a higher risk of cancer after DMT initiation.

CONCLUSIONS:

We report a lower than expected number of cancer cases in MS patients compared to the general population. MS patients with a personal history of cancer were more likely to report DMT use suggesting that DMTs may abrogate the lower incidence of cancer in MS.

The abstract can be seen here.
MS Speaks--online for 13 years

SPMS, diagnosed 1980. Avonex 2001-2004. Copaxone 2007-2010.

 

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