Biologic Therapy in Psoriasis: No Significant Increase in Cancer Risk

A comprehensive literature review published in Expert Opinion on Biological Therapy has found no significant increase in malignancy risk associated with biologic therapies for psoriasis. The findings provide reassurance for clinicians prescribing biologic treatments for difficult-to-treat patients, including those with a history of cancer. 

The study, which analyzed MEDLINE/PUBMED articles published up to November 2024, evaluated the complex relationship between psoriasis, immunomodulatory therapies, and cancer risk. The review focused on 4 key areas: 

• Overall cancer risk in patients with psoriasis 
• Role of cytokines in tumor development 
• Incidence of new malignancies with biologic therapy
• Risk of recurrence or progression in patients with prior cancer who receive biologics 

The analysis concluded that biologic therapies do not significantly elevate malignancy risk compared to non-biologic treatments or the general population. This is an important consideration for dermatologists who may be hesitant to initiate biologics in high-risk patients. 

"Evidence is also reassuring for patients with prior malignancy, showing no tumor progression or recurrence," the study reported. This finding challenges the long-standing concern that biologics could reactivate or worsen pre-existing cancer. 

Despite these findings, the authors emphasized that routine cancer screenings and risk-factor management remain critical for patients with psoriasis receiving immunomodulatory treatments. They recommend a multidisciplinary approach for patients with active or advanced oncologic disease, involving collaboration between dermatologists and oncologists. 

"Regular cancer screenings and risk-factor minimization should always be recommended for psoriatic patients undergoing immunomodulatory therapies," the study stated. 

These findings support the timely use of biologics in patients with moderate-to-severe psoriasis, including those with prior malignancies, reinforcing their safety profile while underscoring the importance of ongoing oncologic surveillance.

Reference
Bruni M, Lobefaro F, Pellegrini C, et al. Psoriasis and cancer: the role of inflammation, immunosuppression, and cancer treatment. Expert Opin Biol Ther. Published online March 4, 2025. doi:10.1080/14712598.2025.2471093