Biológicos y cáncer: ¿una relación peligrosa?

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.