Researchers Find No Tumor Recurrence, Progression in Patients Receiving Biologic for Psoriasis

A new set of real-world data show no concerns of cancer recurrence or progression in patients with a recent personal history of cancer who are receiving biologic treatment for psoriasis. The retrospective findings, published in Dermatology and Therapy, also add to mounting evidence of the efficacy of secukinumab in the condition.

Data on the use of biologics for psoriasis among patients with a history of cancer have remained sparse. With their recent findings, the group provides the largest amount of real-world data on the use of the biologic secukinumab in these patients.

The multicenter data showed that none of the 42 adult patients experienced recurrence or progression of cancer over a mean of 56 weeks of treatment for their moderate to severe plaque psoriasis, including in the 2 patients with metastatic disease.

“Considering the lack of direct association between anti-IL-17 agents and cancer development and the absence of cancer recurrence in population and other case series, to date, there is no evidence to exclude secukinumab for psoriatic patients with a previous diagnosis of malignancy,” explained the researchers. “Indeed, there is increasing evidence that IL-17 inhibition might have a protective role on tumor progression. IL-17 stimulates a proangiogenic and immunosuppressive tumor microenvironment that promotes cell growth and metastasis through induction of inflammatory mediators, contributing to the pathogenesis of a wide range of malignancies.”

More than half (56.8%) of the patients included in the study were diagnosed with a malignancy within 5 years of the study, and 88.1% were diagnosed within 10 years of the study, with a mean time of 3.5 years between cancer diagnosis and secukinumab treatment for psoriasis.

Throughout their time on secukinumab, 3 patients developed a new malignancy, all of which were unrelated to their previous malignancy. The researchers noted that among all 3 patients, they identified high-risk factors for cancer, including a family or personal history and exposure to environmental factors.

“There are limitations to our study that may affect the generalization of results. The relatively small number of patients and the heterogeneity of cancer types and oncological information did not allow us to statistically analyze data, giving only descriptive information,” detailed the group.

“Due to potential fragmentation and inconsistency of information in clinical records, we decided not to collect and describe patients’ history of keratinocytic tumors. In addition, the inclusion of early stage tumors and the short duration of observation might have led us to underestimate the cancer recurrence, although we recognize that our findings are in line with the literature.”

Over the course of treatment, mean Psoriasis Area and Severity Index (PASI) scores among patients improved. With mean scores reaching 17.2 at baseline, there was a 74.7% reduction by week 12, and 88.6% reduction by week 24, and a 91.4% improvement by week 48. By 48 weeks of treatment, 91.2% of patients achieved PASI 75, 64.7% achieved PASI 90, and 38.2% achieved PASI 100, representing a complete resolution of lesions.

Self-reported data on the Dermatology Life Quality Index (DLQI) also continued to improve throughout treatment, dropping from 19.5 at baseline to 4.1 at week 12, 1.7 at week 24, and finally to 1.5 at week 48.

Approximately 10% of patients discontinued treatment because of a lack of efficacy, and adverse events were rare, occurring in 3 patients; these adverse events included fibromyalgia, worsening spongiotic eczema, and dactylitis.

Reference

Pelligrini C, Esposito M, Rossi E, et al. Secukinumab in patients with psoriasis and a personal history of malignancy: a multicenter real-life observational study. Dermatol Ther. 2022;12(11):2613-2626. doi:10.1007/s13555-022-00797-9