Neurol. praxi. 2019;20(2):127-130 | DOI: 10.36290/neu.2019.100
The risk of developing malignant tumors in the modern treatment of multiple sclerosis: a review of the literature
- Interní hematologická a Onkologická klinika FN Brno
Treatment of multiple sclerosis with new generation drugs is a long-term treatment, resulting in monitoring and treatment as well as the risk of serious late side effects such as secondary (induced) malignant tumours. An increased risk of malignancy during immunosuppressive therapy has been demonstrated in patients treated with cytotoxic agents mitoxantrone (MX), methotrexate (MTX) and cyclophosphamide (CFA), immunosuppressive as azathioprine (AZA), however, this assumption has not been confirmed in more modern treatments. We present an overview of Cladribine, Alemtuzumab, and Teriflunomide , where data are not yet unambiguously suspected or rebutted. Therefore, there is a need for careful pre-screening of the parties for the presence of tumors prior to start of this treatment due to a worse prognosis of malignancy and multiple sclerosis and for careful monitoring of patients and reports of all and late potential adverse events treatment because the monitoring period is still short.
Keywords: multiple sclerosis, modern treatment, risk of development cancer
Published: April 23, 2019 Show citation
References
- Comi G, Freedman MS, Kappos L, Olsson TP, Miller AE, Wolinsky JS, O'Connor PWBenamor M, Dukovic D, Truffinet P, Leist TP. Pooled safety and tolerability data from four placebo-controlled teriflunomide studies and extensions. Mult. Scler. Rel. Disord. 2016; 5: 97-104.
Go to original source... 
Go to PubMed... - Cuker A, Stasi R, Palmer J, Oyuela P, Margolin D, Bass A. Successful detection and management of immune thrombocytopenia in alemtuzumab-treated patients with active relapsing-remitting multiple sclerosis (P2.198). Neurology 2014; 82: 2.198. Go to original source...
- FDA warns about rare but serious risks of stroke and blood vessel wall tears with multiple sclerosis drug Lemtrada (alemtuzumab).
- Fraser G, Smith CA, Imrie K, Meyer R, Hematology Disease Site Groupof Cancer Care Ontario's Program in Evidence-Based Care. Alemtuzumab in chronic lymphocytic leukemia. Curr Oncol. 2007; 14(3): 96-109. Go to original source... Go to PubMed...
- Frohman EM, Racke MK, Raine CS. Multiple sclerosis - the plaque and its pathogenesis. N Engl J Med. 2006; 354: 942-955. Go to original source... Go to PubMed...
- Gaitán MI, Ysrraelit MC, Correale J. Neutropenia in Patients With Multiple Sclerosis Treated With Alemtuzumab. JAMA Neurol 2017; 74: 1143. Go to original source... Go to PubMed...
- Giovannoni G, Soelberg, Sorensen P, Cook S, Rammohan K, Rieckemann P, Comi G, Dangond, Adenijini AK, Vernersch P. Safety and efficacy of cladribine tablets in patients with relapsing-remitting multiple sclerosis: Results from the randomized extension trial of the CLARITY study. Mult Scler 2017 Aug 1. Go to original source... Go to PubMed...
- Guarnera C, Bramanti P, Mazzon E. Alemtuzumab: a review of efficacy and risks in the treatment of relapsing remitting multiple sclerosis. Ther Clin Risk Manag. 2017; 13: 871-879. Published 2017 Jul 14. Go to original source... Go to PubMed...
- Huang O, Zhang W, Zhi Q, Xue X, Liu H, Shen D, Jiang M. Featured Article: Teriflunomide, an immunomodulatory drug, exerts anticancer activity in triple negative breast cancer cells. Experimental Biology and Medicine, 2015; 240(4): 426-437. Go to original source... Go to PubMed...
- Kebir S. Prospective observational long-term safety registry of multiple sclerosis patients who have participated in cladribine clinical trials (PREMIERE). ClinicalTrials gov. 2013.
- Lalmohamed A, Bazelier MT, Van Staa TP, Uitdehaag BM, Leufkens HG, De Boer A, De Vries F. Causes of death in patients with multiple sclerosis and matched referent subjects: a population-based cohort study. Eur J Neurol. 2012; 19: 1007-1014. Go to original source... Go to PubMed...
- Marrie RA, Rieder N, Cohen J, Stuve O, Trojano M, Sorensen PS, Riengold SC, Cutter G, Reider N. A systematic review of the incidence and prevalence of cancer in multiple sclerosis" Multiple sclerosis (Houndmills, Basingstoke, England) 2015; 21(3): 294-304. Go to original source... Go to PubMed...
- Merck. Cladribine Tablets Receives Positive CHMP Opinion for Treatment of Relapsing Forms of Multiple Sclerosis. www.prnewswire.co.uk. Retrieved 2017-08-22.
- Moisset X, Perié M, Pereira B, Dumont E, Lebrun-Frenay C, Lesage FX, Duthell F, Taithe F, Clavelou P. Decreased prevalence of cancer in patients with multiple sclerosis: A case-control study. PLoS One. 2017; 12(11): e0188120. Go to original source... Go to PubMed...
- O'Connor P, Comi G, Freedman MS, Miller AE, Kappost L, Bouchard JP, Lebrun-Frenay C, Mares J, Benamor M, Thangavelu K, Liang J, Truffinet P, Lawson JS. Long-term safety and efficacy of teriflunomide: Nine-year follow-up of the randomized TEMSO study Neurology 2016; 86(10): 920-930. Go to original source... Go to PubMed...
- Pakpoor J, Disanto G, Atlman DR, Pavitt S, Turner BP, Marta M, Juliusson G, Baker D, Chataway J, Schmierer K. No evidence for higher risk of cancer in patients with multiple sclerosis taking cladribine. Neurology(R) neuroimmunology & neuroinflammation 2015; 2(6): e158. Go to original source... Go to PubMed...
- Ragonese P, Aridon P, Vazzoler G, Mazzola MA, LoRe V, LoRe M, Realmuto S, Alessi S, D'Angello M, Savettieri G, Salemi G. Association between multiple sclerosis, cancer risk, and immunosuppressant treatment: a cohort study. BMC Neurol. 2017; 17(1): 155. Go to original source...