Introduction:The introduction of biologic therapies and small molecule drugs has revolutionized the management of inflammatory bowel disease (IBD), providing targeted control of inflammation. However, concerns remain regarding their long-term safety profiles, particularly in relation to cancer risk. Chronic inflammation and immunosuppressive therapies contribute to malignancy risk, including skin cancers, such as melanoma and non-melanoma skin cancer (NMSC). This review examines the evidence on skin cancer risks associated with these therapies, focusing on specific drug classes and their mechanisms.Results:Tumor necrosis factor (TNF) inhibitors have shown conflicting evidence regarding melanoma risk, with some studies reporting a modest increase and others finding no significant association. Anti-integrin agents, such as vedolizumab, and interleukin (IL)-12/23 inhibitors, including ustekinumab, have demonstrated favorable safety profiles with minimal skin cancer risks. Selective IL-23 inhibitors and sphingosine-1-phosphate (S1P) receptor modulators have limited long-term data, but early findings indicate a low incidence of skin malignancies. Janus kinase (JAK) inhibitors do not show an increased risk of skin cancers in IBD.Conclusions: Current evidence suggests that skin cancer risk in IBD patients treated with biologics and small molecule drugs varies by drug class. TNF inhibitors and JAK inhibitors are associated with higher risks, while other therapies show lower malignancy risks. Regular skin cancer screening and protective measures remain critical, particularly for patients with additional risk factors. Further long-term studies are essential to refine safety profiles and inform clinical practice in this evolving therapeutic landscape.
引言：生物制剂与小分子药物的引入革新了炎症性肠病（IBD）的治疗策略，实现了对炎症的精准控制。然而，这些药物的长期安全性，尤其是其潜在的癌症风险，仍备受关注。慢性炎症状态及免疫抑制治疗可能增加恶性肿瘤风险，包括黑色素瘤和非黑色素瘤皮肤癌（NMSC）等皮肤癌变。本文综述了相关疗法与皮肤癌风险的证据，重点探讨不同药物类别及其作用机制。 结果：肿瘤坏死因子（TNF）抑制剂与黑色素瘤风险的关系存在争议，部分研究提示风险轻度增加，另一些研究则未发现显著关联。抗整合素药物（如维多珠单抗）及白细胞介素（IL）-12/23抑制剂（如乌司奴单抗）显示出良好的安全性特征，皮肤癌风险极低。选择性IL-23抑制剂和1-磷酸鞘氨醇（S1P）受体调节剂的长期数据有限，但早期研究提示皮肤恶性肿瘤发生率较低。Janus激酶（JAK）抑制剂在IBD治疗中未显示增加皮肤癌风险。 结论：现有证据表明，接受生物制剂与小分子药物治疗的IBD患者，其皮肤癌风险因药物类别而异。TNF抑制剂和JAK抑制剂风险较高，而其他疗法的恶性肿瘤风险相对较低。定期皮肤癌筛查及防护措施至关重要，尤其对于存在其他风险因素的患者。在这一不断发展的治疗领域中，需开展更多长期研究以完善安全性评估，并为临床实践提供指导。
Advanced Therapies for Inflammatory Bowel Disease and Risk of Skin Cancer: What’s New?
肿瘤(癌症)患者之家