scholarly journals Rapid development of multiple nonmelanoma skin cancers secondary to ruxolitinib: a case report

Author(s):  
Trevor A. Nessel ◽  
Jeffrey B. Morris ◽  
Tyler Roshak ◽  
Bryan D. Sofen

<p class="abstract">Janus kinase (JAK) inhibitors are immunosuppressive medications that function by deactivating the JAK-STAT pathway causing inhibition of cellular growth. Ruxolitinib is a JAK inhibitor that is commonly used to treat disease processes such as myelofibrosis, polycythemia vera and graft versus host disease, with some evidence of benefit with prostate cancer as well. Side effects of ruxolitinib include increased risk of infection, pancytopenia, cardiovascular disease and malignancy relating to the medication’s immunosuppressive effects. Here we reported a 69-year-old male with prostate cancer being treated with ruxolitinib who developed multiple nonmelanoma skin cancers over a 13-month period.</p>

2021 ◽  
Vol 2021 ◽  
pp. 1-15
Author(s):  
Elisabetta Bigagli ◽  
Lorenzo Cinci ◽  
Mario D’Ambrosio ◽  
Patrizia Nardini ◽  
Francesca Portelli ◽  
...  

Recent studies reported the association between increased risk of nonmelanoma skin cancers (NMSCs) and the use of hydrochlorothiazide (HCTZ), one of the most commonly prescribed diuretic, antihypertensive drug, over the world. Although HCTZ is known to be photosensitizing, the mechanisms involved in its potential prophotocarcinogenic effects remain unclear. Under acute exposure, therapeutically relevant concentrations of HCTZ (70, 140, and 370 ng/mL) amplified UVA-induced double-strand breaks, oxidative DNA, and protein damage in HaCaT human keratinocytes, and this effect was associated to a defective activity of the DNA repair enzyme, OGG1. Oxidative damage to DNA, but not that to proteins, was reversible within few hours. After chronic, combined exposure to HCTZ (70 ng/mL) and UVA (10 J/cm2), for 9 weeks, keratinocytes acquired a dysplastic-like phenotype characterized by a multilayered morphology and alterations in cell size, shape, and contacts. At the ultrastructural level, several atypical and enlarged nuclei and evident nucleoli were also observed. These transformed keratinocytes were apoptosis resistant, exhibited enhanced clonogenicity capacity, increased DNA damage and inflammation, defective DNA repair ability, and increased expression of the oncogene ΔNp63α and intranuclear β-catenin accumulation (a hallmark of Wnt pathway activation), compared to those treated with UVA alone. None of these molecular, morphological, or functional effects were observed in cells treated with HCTZ alone. All these features resemble in part those of preneoplastic lesions and NMSCs and provide evidence of a biological plausibility for the association among exposure to UVA, use of HCTZ, and increased risk of NMSCs. These results are of translational relevance since we used environmentally relevant UVA doses and tested HCTZ at concentrations that reflect the plasma levels of doses used in clinical practice. This study also highlights that drug safety data should be followed by experimental evaluations to clarify the mechanistic aspects of adverse events.


2015 ◽  
Vol 33 (31) ◽  
pp. 3568-3575 ◽  
Author(s):  
Lucie M. Turcotte ◽  
John A. Whitton ◽  
Debra L. Friedman ◽  
Sue Hammond ◽  
Gregory T. Armstrong ◽  
...  

Purpose Survivors of childhood cancer have an increased risk for subsequent neoplasms (SNs), but the incidence beyond the age of 40 years and associations with therapeutic exposures have not been well described. Patients and Methods Among 14,364 survivors of childhood cancer diagnosed between 1970 and 1986, 3,171 had an attained age of 40 years or older at the time of last contact. Cumulative incidence of SNs, standardized incidence ratios (SIRs), excess absolute risk of subsequent malignant neoplasms (SMNs), and relative risks (RRs) for SMNs and nonmelanoma skin cancers were calculated. Results In total, 679 SNs were diagnosed in patients age 40 years or older. These included 196 SMNs, 419 nonmelanoma skin cancers, 21 nonmalignant meningiomas, and 43 other benign neoplasms. At age 55 years, the cumulative incidence of new SNs and SMNs occurring after age 40 years was 34.6% (95% CI, 28.7 to 40.6) and 16.3% (95% CI, 11.7 to 20.9), respectively. Survivors were four times as likely as the general population to receive a diagnosis of SMN after age 40 years (SIR, 4.4; 95% CI 3.8 to 5.0). Among SMNs, risk was most increased for soft tissue sarcoma (SIR, 12.3; 95% CI, 7.2 to 21.0), breast cancer (SIR, 8.3; 95% CI, 6.9 to 10.0), renal cancer (SIR, 6.1; 95% CI, 3.2 to 11.6), and thyroid cancer (SIR, 5.1; 95% CI, 2.8 to 9.4). Female sex (RR, 1.5; 95% CI, 1.1 to 2.1; P = .008), platinum chemotherapy (RR, 3.4; 95% CI, 1.5 to 7.7; P = .003), epipodophyllotoxins (RR, 2.4; 95% CI, 1.0 to 5.8; P = .05), and therapeutic radiation exposure (RR, 2.0; 95% CI, 1.4 to 3.1; P < .001) were associated with higher risk for SMN in multivariable analysis. Conclusion Even after age 40 years, survivors of childhood cancer remain at increased risk for treatment-related SNs. These data suggest the need for life-long monitoring and should inform anticipatory guidance provided to survivors of childhood cancer.


2011 ◽  
Vol 141 (5) ◽  
pp. 1621-1628.e5 ◽  
Author(s):  
Laurent Peyrin–Biroulet ◽  
Kiarash Khosrotehrani ◽  
Fabrice Carrat ◽  
Anne–Marie Bouvier ◽  
Jean–Baptiste Chevaux ◽  
...  

2011 ◽  
Vol 141 (5) ◽  
pp. 1612-1620 ◽  
Author(s):  
Harminder Singh ◽  
Zoann Nugent ◽  
Alain A. Demers ◽  
Charles N. Bernstein

2021 ◽  
pp. 542-546
Author(s):  
Miłosz Lewandowski ◽  
Paweł Łukowicz ◽  
Jerzy Jankau ◽  
Jan Romantowski ◽  
Wioletta Barańska-Rybak

Hydroxyurea therapy is commonly used in the treatment of patients suffering from myeloproliferative diseases, such as polycythemia vera. It is supported by evidence that this type of therapy can generate mild skin lesions like leg ulcers, erythema, and hyperpigmentation. There are also some studies that show an increased risk of development of nonmelanoma skin cancers. We report a 56-year-old man with a 13-year history of polycythemia vera, treated chronically with hydroxyurea. In April 2020, the patient presented a skin lesion on the forehead, skin horn on the left forearm, and hyperkeratosis on the rims of both ears. In the patient’s history, in October 2019, complete excision of the skin lesion in the central area of the forehead was performed. After 4 months, a new skin lesion appeared at the same area of the forehead, which in May 2020 after resection in the histopathological examination was diagnosed as recurrence of squamous cell carcinoma. The aim of the case is to draw the clinicians’ attention to the increased risk of squamous cell carcinoma and basal cell carcinoma in patients treated with hydroxyurea. Increased vigilance would make it possible to recognize them earlier, and thus potentially reduce the undesirable effects associated with the delayed radical treatment of these skin cancers. Randomized clinical trials assessing the potential benefits of oral retinoids for chemoprevention of nonmelanoma skin cancers in the hydroxyurea-treated population should also be considered.


2020 ◽  
Author(s):  
Rui Pu ◽  
Hongru Sun ◽  
Yupeng Liu ◽  
Tian Tian ◽  
Haoran Bi ◽  
...  

Abstract Background: The Janus kinase-signal transducer and activator of transcription (JAK-STAT) pathway is involved in a series of biological processes. Aberrant promoter methylation of CpG islands plays an important role in carcinogenesis. However, the association between the DNA methylation of JAK-STAT pathway-related genes in peripheral blood leukocytes and colorectal cancer (CRC) susceptibility remains unclear. Methods: We conducted a case-control study of 403 patients with CRC and 419 cancer free controls, and the DNA methylation levels of four genes (JAK2, STAT1, STAT3, and SOCS3) in peripheral blood samples from all subjects were assessed using a methylation-sensitive high-resolution melting (MS-HRM) analysis. Results: Compared with controls, the methylation of the JAK2, STAT1 and SOCS3 genes significantly increased the CRC risk (ORadjusted=1.96, 95% CI, 1.12-3.41, P=0.01; ORadjusted=5.37, 95% CI, 3.74-7.71, P<0.01; ORadjusted=3.30, 95% CI, 1.58-6.87, P<0.01, respectively). This trend was also found via stratified analysis. In the multiple CpG site methylation (MCSM) analysis, a high MCSM value denoted a significantly increased risk of CRC (ORadjusted=4.97, 95% CI, 3.34-7.37, P<0.01). Antagonistic interactions were identified between the methylation of JAK2, STAT1 and high levels of MCSM and environmental factors with CRC risk (P<0.05). Conclusion: In peripheral blood, the methylation statuses of JAK2, STAT1, and high levels of MCSM, which are promising biomarkers, were significantly associated with CRC risk. An interaction between gene methylation and environmental factors contributed to the risk of CRC.


2012 ◽  
Vol 39 (4) ◽  
pp. 712-715 ◽  
Author(s):  
PIERRE LE BLAY ◽  
GAEL MOUTERDE ◽  
THOMAS BARNETCHE ◽  
JACQUES MOREL ◽  
BERNARD COMBE

Objective.To assess the risk of total malignancy and nonmelanoma skin cancers (NMSC) in patients with rheumatoid arthritis (RA) receiving certolizumab and golimumab through a metaanalysis of data from randomized control trials (RCT).Methods.We systematically reviewed the literature up to May 2011 in Medline databases, as well as abstracts from the 2009 and 2010 annual meetings of the European League Against Rheumatism and the American College of Rheumatology. Mantel-Haenszel method was used to determine a common odds ratio (OR). Statistical heterogeneity was assessed by chi-square Q test. We selected only RCT including more than 30 RA subjects randomly assigned to an anti-tumor necrosis factor (TNF) or a nonbiological disease-modifying antirheumatic drug (DMARD) control group.Results.The literature search identified 793 articles; 6 (2 with certolizumab and 4 with golimumab) were selected for metaanalysis. A total of 2710 patients received at least 1 dose of certolizumab or golimumab. For anti-TNF-treated patients, 18 cancers (excluding NMSC) and 9 NMSC were observed versus 4 cases of total malignancy and 3 NMSC in control groups. Metaanalysis revealed a pooled OR of 1.06 (95% CI 0.39–2.85) for risk of total malignancy and 0.69 (95% CI 0.23–2.11) for risk of NMSC with certolizumab and golimumab versus DMARD. Heterogeneity was not significant.Conclusion.Metaanalysis of RCT of golimumab and certolizumab did not find an increased risk of total malignancy and NMSC. These results must be confirmed with longterm extension studies and registry studies, and careful monitoring remains mandatory.


Cancers ◽  
2021 ◽  
Vol 13 (4) ◽  
pp. 587
Author(s):  
Danuta Krasowska ◽  
Agnieszka Gerkowicz ◽  
Radosław Mlak ◽  
Milena Leziak ◽  
Teresa Małecka-Massalska ◽  
...  

Patients with Parkinson’s disease (PD) have an increased risk of melanoma compared with the general population. Considering that Nonmelanoma Skin Cancers (NMSCs) share similar risk factors with melanoma, there is a need to understand a possible connection between PD and NMSCs. The aim of the study was the evaluation of NMSC risk among PD patients via meta-analysis and systematic review. A comprehensive search of PubMed, Scopus, and Web of Science databases was conducted, including studies from January 2000 to April 2020. We identified 16 eligible studies including 140291 PD patients. Upon statistical analysis, a significantly higher risk of developing NMSCs in PD patients was found compared with the control group (odds ratio (OR) = 1.25, 95% CI: 1.17–1.33; p < 0.0001). Among all NMSCs, the risk of developing basal cell carcinoma in PD patients was significantly higher (OR = 1.30, 95% confidence interval (CI): 1.15–1.47; p < 0.0001), contrary to squamous cell carcinoma. Further analysis revealed a significantly higher risk of developing NMSCs in patients with previously diagnosed PD (OR = 1.26, 95% CI: 1.19–1.33; p < 0.0001). Our data suggest the necessity for regular skin examination of PD patients, though further studies are required to explore the mechanisms forming this relationship.


2019 ◽  
Vol 2019 ◽  
pp. 1-15 ◽  
Author(s):  
Florah Tshepo Moshapa ◽  
Kirsten Riches-Suman ◽  
Timothy Martin Palmer

Type 2 diabetes mellitus (T2DM) is increasing worldwide, and it is associated with increased risk of coronary artery disease (CAD). For T2DM patients, the main surgical intervention for CAD is autologous saphenous vein grafting. However, T2DM patients have increased risk of saphenous vein graft failure (SVGF). While the mechanisms underlying increased risk of vascular disease in T2DM are not fully understood, hyperglycaemia, insulin resistance, and hyperinsulinaemia have been shown to contribute to microvascular damage, whereas clinical trials have reported limited effects of intensive glycaemic control in the management of macrovascular complications. This suggests that factors other than glucose exposure may be responsible for the macrovascular complications observed in T2DM. SVGF is characterised by neointimal hyperplasia (NIH) arising from endothelial cell (EC) dysfunction and uncontrolled migration and proliferation of vascular smooth muscle cells (SMCs). This is driven in part by proinflammatory cytokines released from the activated ECs and SMCs, particularly interleukin 6 (IL-6). IL-6 stimulation of the Janus kinase (JAK)/signal transducer and activator of transcription 3 (STAT) pathway is a key mechanism through which EC inflammation, SMC migration, and proliferation are controlled and whose activation might therefore be enhanced in patients with T2DM. In this review, we investigate how proinflammatory cytokines, particularly IL-6, contribute to vascular damage resulting in SVGF and how suppression of proinflammatory cytokine responses via targeting the JAK/STAT pathway could be exploited as a potential therapeutic strategy. These include the targeting of suppressor of cytokine signalling (SOCS3), which appears to play a key role in suppressing unwanted vascular inflammation, SMC migration, and proliferation.


Sign in / Sign up

Export Citation Format

Share Document