Should TNF Inhibitors Be Used in Patients with Prior Malignancies?

Rheumatologists often see patients who have rheumatoid arthritis (RA) and histories of malignancy. Past research suggests that tumor necrosis factor (TNF) inhibitor use is not associated with cancer recurrence, and American College of Rheumatology guidelines do not recommend avoiding these agents, except in patients with histories of lymphoma or melanoma (Arthritis Care Res (Hoboken) 2016; 68:1). Despite this guidance, some clinicians still are reluctant to prescribe TNF inhibitors to cancer survivors. Using Swedish cancer registries, these investigators assessed whether TNF inhibitors are associated with excess risk for cancer recurrence.

A total of 467 RA patients who started TNF inhibitors after their cancer diagnoses (exposed group) were…