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Cancer

Naysayers & Disrupters (3.22.2024)

Dr. Jack Cush reviews the news and journal reports from the past week - including a few contrary reports on infection, seropositivity and plasmapheresis.

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Ides of March (3.15.2024)

Dr. Jack Cush has advice for Caesar and the superstitious, and covers pregnancy, platelets, dialysis and vaccinations in Lupus.





  1. Dutch study of 586 RA pts on bDMARDs found more nonserious infections (NSIE) (77/100PYs) than serious infx (SIE)(1.3/100Pys). Upper respiratory

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DANBIO #RA registry study: in 21,982 Rx starts (96K PtYrs) saw 1423 cancers w/ no overall increase in cancer risk with tocilizumab, sarilumab, abatacept, or rituximab (HRs from 0.7–1.1). No diff betw ABA vs TNFi (HR 1.41) nor HEME CA RTX vs TNFi (HR 0.09) https://t.co/mIEqALnnwI https://t.co/N1v3TzuBGm
Dr. John Cush @RheumNow( View Tweet )
H. Pylori is usually acquired during childhood, remains dormant until activated years later. Is assoc w/ PUD and gastric cancer, not dyspepsia. Baylor Univ Grand Round By Dr. Byron Cryer @BCryer https://t.co/KXZfigVYX9
Dr. John Cush @RheumNow( View Tweet )
"In solid tumors, treat your RA patient as if they do not have a cancer, meaning do not change your therapy if the patient is responding well. Things may get dicey if hematologic malignancy." @RheumNow #RWCS24 I work w/ my onc team to ensure the patient has the needed support.

Dr. Rachel Tate @uptoTate( View Tweet )

Danish registries study shows maternal Autoimmune Dzs (all) were assoc w/ incr risk of childhood cancers (OR=1.25, 95% CI 1.06, 1.47), acute lymphoblastic leukemia (OR =1.52), Burkitt lymphoma (OR=2.6) & CNS tumors (OR=1.45); same seen for RA mothers https://t.co/HQO972ch9R https://t.co/dDEJUo8unq
Dr. John Cush @RheumNow( View Tweet )
Cancer and Myositis #RNL2024 @RheumNow @DrLisaCS on Cancer screening: Risk stratify: dermatomyositis, NXP2, TIFy, <40yo, refractory, dysphagia, cutaneous necrosis at higher risk Enhanced risk stratification for those at risks, versus "basic screening" for lower risks https://t.co/3yy9Fx1pk8
Eric Dein @ericdeinmd( View Tweet )
JAK toxicity of interest. Eric Ruderman #RNL2024 @RheumNow https://t.co/qdlJFKTUR8
Nouf Al hemmadi @NoufAhmedAlham2( View Tweet )
While NSAID use has been assoc w/ lower risk of cancers (CNS, breast, esophageal, gastric, head & neck, hepatocellular, cholangiocarcinoma, colorectal, endometrial, lung, ovary, prostate, pancreatic); NSAIDs should not be used to prevent cancers https://t.co/YcsU7x7iy0 https://t.co/QJjHqjnuEo
Dr. John Cush @RheumNow( View Tweet )

Increased CV Comorbidity in Dermatomyositis

A cohort study suggest that patients with dermatomyositis (DM) are at an increased risk for multiple comorbidities, including chronic kidney and cardiovascular disease,

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RA and cancer risk in the biologic era RA is known to be historically associated with site specific cancers, especially lung skin and lymphomas. This risk was described as likely to be supported by chronic systemic inflammation before the biologic era. https://t.co/ZOWFKTg3l3 https://t.co/1VLWgxVb0W
Dr. John Cush @RheumNow( View Tweet )

ICYMI: Cancer and TNF inhibitors

Cancer risk minimisation is a high priority for people with rheumatic diseases, as it is for the general population. Tumor necrosis factor inhibitors (TNFi) have a long history of association with cancer risk discussions. An oral presentation by Suarez-Almazor et al provided more supportive data

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FDA Warning on CAR-T Cell Therapy

On Nov. 28, 2024, FDA issued a safety alert regarding CAR-T cell immunotherapies; noting reports of T-cell malignancies (CAR-positive lymphoma) arising in patients treated with BCMA- or CD19-directed autologous CAR T cell immunotherapies and that if there is a risk, this only applies to

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ICYMI: Are Rheumatologists doing Enough for Cervical Cancer?

Should rheumatologists be counseling patients on cervical cancer prevention and screening? The data from Abstract

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Are Rheumatologists doing Enough for Cervical Cancer? Should rheums be counseling patients on cervical cancer prevention and screening? The data from Abstract #1479 at #ACR23 suggests this should be an important conversation with our lupus patients. https://t.co/VFobM0T3u7 https://t.co/L45N3tsTdN
Dr. John Cush @RheumNow( View Tweet )

Are Rheumatologists doing Enough for Cervical Cancer?

Should rheumatologists be counseling patients on cervical cancer prevention and screening? The data from Abstract

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#ACR23 Abstr#2575 Do guidelines work? Data from UK cohort (N=290) re: utility of the International Guideline for IIM-assoc cancer screening detected 17 cases; most in high risk group & none in low risk. Need larger size, cases, screening timepoint & economic analysis @RheumNow https://t.co/G2bmmQbSox
Md Yuzaiful Md Yusof ( View Tweet )
Lung cancer in RA. @NamrataRheum et al. 26,625 RA HR for lung cancer for b/tsDMARDs vs csDMARDS 1.07 (0.91-1.26) Abstr#0453 #ACR23 @RheumNow https://t.co/NLNtyYoaoH https://t.co/tRpt62n62X
Richard Conway ( View Tweet )
Age does NOT affect the chance of getting irAE or the severity when using check point inhibitors to treat cancer. Data from #CANRIO database in #Canada #ACR 23 @ACRheum @RheumNow #1063 https://t.co/bqbiXzdAqr
Janet Pope ( View Tweet )
Obs study, bDMARDs & malignancy TNFi w/lower risk than ABA/RTX/IL6i & numerically lower than JAKs I'm a little skeptical... KM curves diverged w/~45 days, seems implausible? Agree w/first author, possible channeling bias @RheumNow #ACR23 Abstr 1678 https://t.co/1uL3j6kTSj
Mike Putman @EBRheum( View Tweet )

Cancer and TNF inhibitors

Cancer risk minimisation is a high priority for people with rheumatic diseases, as it is for the general population. Tumor necrosis factor inhibitors (TNFi) have a long history of association with cancer risk discussions. An oral presentation by Suarez-Almazor et al provided more supportive data

Read Article

#ACRbest Abstracts – Day 2

Our reporters have been prolific in finding the hot abstracts, those that were most attended or those that are getting the most buzz on social media.  Here are RheumNow's #ACRbest abstract reports from Monday, November 13, 2023 at #ACR23, covering The Great Debate, SGLPT2 inhibitors in SLE

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Large observational study of TNF use among patients with RA & cancer Overall encouraging, no negative impact on survival I'm kind of a TNF-truther on this; I don't think they cause ANY increased risk of malignancy @RheumNow #ACR23 Abstr 1675 https://t.co/KRVlIFxhl8
Mike Putman @EBRheum( View Tweet )
2 RA cohorts w/Breast Cancer 17% TNFi within 1yr after surgery No diff in overall survival at 5 yr w/ TNFi or csDMARD Trend towards better BC specific survival w/ TNFi vs. csDMARD only Worst survival for GC>7.5mg/day Only 2 yrs follow up @RheumNow #ACR23 ABST1675 https://t.co/ekKlJ2dP5i
Aurelie Najm ( View Tweet )
1-Can we prevent RA ? Vagotomy? 2-CV events in auto immune rheumatic disease pregnancies. 3-CVS vasculitis , challenges and role of Brain biopsy And others…….. https://t.co/BX8bDSX1M3 @RheumNow , daily recap #ACR23

Nouf Al hemmadi ( View Tweet )