In a new study entitled “Better survival of renal cell carcinoma in patients with inflammatory bowel disease”, researchers investigated whether the commonly used immunosuppressive and anti-TNFα therapies in inflammatory bowel disease (IBD) affect a patients’ risk to develop cancer, especially renal cell carcinoma (RCC). The study was published in the journal Oncotarget.
IBD comprises a group of diseases characterized by chronic inflammation of the gastrointestinal tract, with Crohn’s disease (CD) and Ulcerative Colitis (UC) as the two main types of IBD. Treatment of IBD may include the use of immunosuppressive medication (drugs that suppress the immune system), although this type of medication, together with the intrinsic inflammatory status of IBD, has led IBD patients more susceptible to other intestinal and non-intestinal malignancies. Particularly, due to IBD patients’ need for a long-term use of immunosuppressants, the risk for cancer such as RCC is a concern growing among the IBD research field. However, current data regarding the risk for IBD patients to develop RCC is lacking.
The research team investigated the risk factors for RCC development, and compared IBD patients and the general population for RCC characteristics, outcome and survival. To this end, the team identified from an IBD patients cohort in the Netherlands, 180 IBD patients with RCC.
The team identified that pancolitis (a very severe form of ulcerative colitis that involves the entire large intestine), penetrating Crohn’s disease, IBD related surgery, male patients and older age are independent risk factors for RCC development. They discovered that IBD patients are usually younger at the time of diagnosis and exhibit a lower RCC stage, when compared to an RCC cohort from the general population. These results lead IBD patients to have better disease free and overall survival.
Notably, it was found that immunosuppressive therapy (as well as anti-TNFα treatment, since TNFα has been shown to play a critical role in the pathogenesis of IBD) do not carry a negative impact in both parameters (disease free and overall survival) in IBD patients diagnosed with RCC.
Hence, the team highlights that their findings suggest that IBD patients with a complex phenotype have a greater risk to develop RCC, but since IBD patients are diagnosed at younger ages and in earlier disease stages they exhibit a better survival outcome (which is therefore independent of their use of immunosuppressive or anti-TNFα therapy).