A Multidisciplinary Approach to Patients with Psoriasis and a History of Malignancies or On-Treatment for Solid Tumors: A Narrative Literature Review.
Nerina DenaroGianluca NazzaroGiulia MurgiaFederica ScarfìCarolina CauchiCarlo Giovanni CarreraAngelo CattaneoCinzia SolinasMario ScartozziAngelo Valerio MarzanoOrnella GarroneEmanuela PassoniPublished in: International journal of molecular sciences (2023)
Psoriasis is a chronic immune-mediated disease that is linked to an increased risk of cancer. Although numerous studies have explored whether neoplasms are concurrent conditions or are induced by psoriasis, a definitive definition remains elusive. In this study, we conducted a comprehensive narrative literature review to offer practical guidance to oncologists and dermatologists regarding the initiation and discontinuation of biologics for psoriasis. The findings indicate that a customized approach is recommended for each patient, and that a history of malignancies does not constitute an absolute contraindication for biologics. Growing evidence supports the treatment of selected patients, emphasizing a nuanced assessment of benefits and risks. There is a lack of data specifying a safe timeframe to initiate biologics following a neoplasm diagnosis due to influences from cancer-related and patient-specific characteristics impacting prognosis. Some patients may continue anti-psoriasis therapy during cancer treatments. Enhanced comprehension of the biological mechanisms in cancer progression and the immune microenvironment of psoriasis holds promise for refining therapeutic strategies. In conclusion, a personalized treatment approach necessitates collaboration between oncologists and dermatologists, considering factors such as cancer prognosis, psoriasis clinical manifestations, patient characteristics, and preferences when making treatment decisions.
Keyphrases
- papillary thyroid
- end stage renal disease
- case report
- chronic kidney disease
- squamous cell
- newly diagnosed
- squamous cell carcinoma
- atopic dermatitis
- stem cells
- young adults
- prognostic factors
- machine learning
- radiation therapy
- combination therapy
- childhood cancer
- risk assessment
- rectal cancer
- high grade
- lymph node metastasis
- palliative care
- decision making
- human health