Decreased risk of cancer in multiple sclerosis patients and analysis of the effect of disease modifying therapies on cancer risk

Gaindh, Deeya; Kavak, Katelyn; Teter, Barbara; Vaughn, Caila B.; Cookfair, Diane L.; Hahn, Theresa; Weinstock‐Guttman, Bianca

doi:10.1016/j.jns.2016.09.005

Cited by 24 publications

(21 citation statements)

References 19 publications

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“…A number of studies have reported the lower risk of cancer in MS patients compared to patients with other autoimmune diseases [18,19]. In line with these studies NK cells, in addition to BCR and TCR signalling pathways as representatives of innate and adoptive immune systems, respectively, were enriched significantly in the NDP group.…”

Section: Discussionsupporting

confidence: 58%

“…systemic lupus erythematosus (SLE) and rheumatoid arthritis (RA) [15][16][17][18][19]. systemic lupus erythematosus (SLE) and rheumatoid arthritis (RA) [15][16][17][18][19].…”

Section: Introductionmentioning

confidence: 99%

“…In comparison with MS patients, risk of cancers such as lung cancer and non-Hodgkin's lymphoma (NHL) is higher in patients with autoimmune diseases, e.g. systemic lupus erythematosus (SLE) and rheumatoid arthritis (RA) [15][16][17][18][19]. Accordingly, we have evaluated the autoantibody repertories in patients with non-small-cell lung cancer [20], NHL [21], SLE, RA (in press) and MS to find common events and indeed common targets.…”

Section: Introductionmentioning

confidence: 99%

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A systems medicine approach reveals disordered immune system and lipid metabolism in multiple sclerosis patients

Pazhouhandeh

Sahraian

Siadat

et al. 2018

Clinical and Experimental Immunology

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Identification of autoimmune processes and introduction of new autoantigens involved in the pathogenesis of multiple sclerosis (MS) can be helpful in the design of new drugs to prevent unresponsiveness and side effects in patients. To find significant changes, we evaluated the autoantibody repertoires in newly diagnosed relapsing-remitting MS patients (NDP) and those receiving disease-modifying therapy (RP). Through a random peptide phage library, a panel of NDP- and RP-specific peptides was identified, producing two protein data sets visualized using Gephi, based on protein--protein interactions in the STRING database. The top modules of NDP and RP networks were assessed using Enrichr. Based on the findings, a set of proteins, including ATP binding cassette subfamily C member 1 (ABCC1), neurogenic locus notch homologue protein 1 (NOTCH1), hepatocyte growth factor receptor (MET), RAF proto-oncogene serine/threonine-protein kinase (RAF1) and proto-oncogene vav (VAV1) was found in NDP and was involved in over-represented terms correlated with cell-mediated immunity and cancer. In contrast, transcription factor RelB (RELB), histone acetyltransferase p300 (EP300), acetyl-CoA carboxylase 2 (ACACB), adiponectin (ADIPOQ) and phosphoenolpyruvate carboxykinase 2 mitochondrial (PCK2) had major contributions to viral infections and lipid metabolism as significant events in RP. According to these findings, further research is required to demonstrate the pathogenic roles of such proteins and autoantibodies targeting them in MS and to develop therapeutic agents which can ameliorate disease severity.

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Section: Discussionsupporting

confidence: 58%

“…systemic lupus erythematosus (SLE) and rheumatoid arthritis (RA) [15][16][17][18][19]. systemic lupus erythematosus (SLE) and rheumatoid arthritis (RA) [15][16][17][18][19].…”

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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A systems medicine approach reveals disordered immune system and lipid metabolism in multiple sclerosis patients

Pazhouhandeh

Sahraian

Siadat

et al. 2018

Clinical and Experimental Immunology

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“…Urogenital (3,11), central nervous system (8,12), and skin cancers (1, 13) appear to be higher in the MS population. Several studies have found that while cancer risk in MS patients may not differ from the general population, the risk appears to be lower in male patients compared to female patients, and increases with age (7,14,15). Overall, there is general agreement that immunosuppressant therapies, such as azathioprine, methotrexate, cyclophosphamide, and mitoxantrone have led to increased cancer risks in MS patients and this risk is related to patient's family history of cancer, duration of treatment and cumulative dose (16,17).…”

Section: Introductionmentioning

confidence: 99%

Multiple Sclerosis and Cancer: The Ying-Yang Effect of Disease Modifying Therapies

Melamed

Lee

2020

Front. Immunol.

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Over the past two decades, the field of multiple sclerosis (MS) has been transformed by the rapidly expanding arsenal of new disease modifying therapies (DMTs). Current DMTs for MS aim to modulate innate and adaptive immune responses toward a less inflammatory phenotype. Since the immune system is also critical for identifying and eliminating malignant cells, immunosuppression from DMTs may predictably increase the risk of cancer development in MS patients. Compared with healthy controls, patients with autoimmune conditions, such as MS, may already have a higher risk of developing certain malignancies and this risk may further be magnified by DMT treatments. For those patients who develop both MS and cancer, these comorbid presentations create a challenge for clinicians on how to therapeutically address management of cancer in the context of MS autoimmunity. As there are currently no accepted guidelines for managing MS patients with prior history of or newly developed malignancy, we undertook this review to evaluate the molecular mechanisms of current DMTs and their potential for instigating and treating cancer in patients living with MS.

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“…With some notable exceptions, 3,5 most studies on the risk of cancer in MS are based on administrative data, which are collected to inform on management issues rather than research purposes, 6,[16][17][18] or surveys and questionnaires. 19,20 Only one previous study has compared cancer risk within family, reporting an increased cancer risk among fathers compared with their offspring with MS. 3 We therefore conducted a large population-based cohort study with data retrieved from national registries and published population studies to collect objective and reliable information on the risk of cancer among MS patients. The aim was to investigate the risk of cancer in MS prospectively.…”

Section: Introductionmentioning

confidence: 99%

Risk of cancer among multiple sclerosis patients, siblings, and population controls: A prospective cohort study

et al. 2019

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Background: Risk of cancer in multiple sclerosis (MS) patients compared to their siblings is unknown. Objective: The objective was to prospectively investigate the risk of cancer among MS patients compared to siblings without MS and to population controls. Methods: We retrieved data on MS patients born between 1930 and 1979 from the Norwegian Multiple Sclerosis Registry and population studies and on cancer diagnosis from the Cancer Registry of Norway. We used adjusted Cox proportional hazard regression to estimate cancer risk among 6883 MS patients, 8918 siblings without MS, and 37,919 population controls. Results: During 65 years of follow-up, cancer risk among MS patients was higher than that among population controls (hazard ratio (HR) = 1.14, 95% confidence interval (CI): 1.05–1.23) in respiratory organs (HR = 1.66, 95% CI: 1.26–2.19), urinary organs (HR = 1.51, 95% CI: 1.12–2.04), and the central nervous system (HR = 1.52, 95% CI: 1.11–2. 09). Siblings had higher risk of hematological cancers compared with MS patients (HR = 1.82, 95% CI: 1.21–2.73) and population controls (HR = 1.72, 95% CI: 1.36–2.18). Conclusion: MS patients were associated with increased risk of cancer compared to population controls. Siblings had increased risk of hematological cancer. This indicates that MS and hematological cancer could share a common etiology.

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Decreased risk of cancer in multiple sclerosis patients and analysis of the effect of disease modifying therapies on cancer risk

Cited by 24 publications

References 19 publications

A systems medicine approach reveals disordered immune system and lipid metabolism in multiple sclerosis patients

A systems medicine approach reveals disordered immune system and lipid metabolism in multiple sclerosis patients

Multiple Sclerosis and Cancer: The Ying-Yang Effect of Disease Modifying Therapies

Risk of cancer among multiple sclerosis patients, siblings, and population controls: A prospective cohort study

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