{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,26]],"date-time":"2026-09-26T05:26:18Z","timestamp":1790400378624,"version":"4.1.0"},"reference-count":36,"publisher":"MDPI AG","issue":"7","license":[{"start":{"date-parts":[[2025,3,21]],"date-time":"2025-03-21T00:00:00Z","timestamp":1742515200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cancers"],"abstract":"<jats:p>The use of advanced therapies, including biologics and small molecules, has become an established clinical practice for the treatment of moderate-to-severe ulcerative colitis (UC) and Crohn\u2019s disease (CD). However, certain patient populations, such as those with a history of cancer, are often excluded from clinical trials evaluating the efficacy and safety of these therapies. This exclusion has historically left clinicians with limited evidence to guide treatment decisions in this high-risk group. Nevertheless, emerging real-world data and updated guidelines increasingly support the safe use of advanced therapies in patients with a prior malignancy. Risk stratification and a multidisciplinary approach, including oncologist input, remain critical in optimizing patient outcomes by assessing both cancer recurrence risk and disease activity. This review aims to provide a comprehensive overview of the current evidence, address existing knowledge gaps, and offer practical insights for the management of IBD in patients with a history of cancer.<\/jats:p>","DOI":"10.3390\/cancers17071057","type":"journal-article","created":{"date-parts":[[2025,3,21]],"date-time":"2025-03-21T07:25:00Z","timestamp":1742541900000},"page":"1057","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Management of Patients with IBD and History of Cancer"],"prefix":"10.3390","volume":"17","author":[{"given":"Ilaria","family":"Faggiani","sequence":"first","affiliation":[{"name":"Department of Gastroenterology and Endoscopy I, IRCCS San Raffaele Hospital and Vita-Salute San Raffaele University, 20132 Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3844-3483","authenticated-orcid":false,"given":"Sarah","family":"Bencardino","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Endoscopy I, IRCCS San Raffaele Hospital and Vita-Salute San Raffaele University, 20132 Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mariangela","family":"Allocca","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Endoscopy I, IRCCS San Raffaele Hospital and Vita-Salute San Raffaele University, 20132 Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Federica","family":"Furfaro","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Endoscopy I, IRCCS San Raffaele Hospital and Vita-Salute San Raffaele University, 20132 Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alessandra","family":"Zilli","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Endoscopy I, IRCCS San Raffaele Hospital and Vita-Salute San Raffaele University, 20132 Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tommaso Lorenzo","family":"Parigi","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Endoscopy I, IRCCS San Raffaele Hospital and Vita-Salute San Raffaele University, 20132 Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-5400-2765","authenticated-orcid":false,"given":"Clelia","family":"Cicerone","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Endoscopy I, IRCCS San Raffaele Hospital and Vita-Salute San Raffaele University, 20132 Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Virginia","family":"Solitano","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Endoscopy I, IRCCS San Raffaele Hospital and Vita-Salute San Raffaele University, 20132 Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laurent","family":"Peyrin-Biroulet","sequence":"additional","affiliation":[{"name":"INSERM NGERE, Department of Gastroenterology, INFINY Institute, CHRU Nancy, F-54500 Vand\u0153uvre-l\u00e8s-Nancy, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7341-1351","authenticated-orcid":false,"given":"Silvio","family":"Danese","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Endoscopy I, IRCCS San Raffaele Hospital and Vita-Salute San Raffaele University, 20132 Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8591-6995","authenticated-orcid":false,"given":"Ferdinando","family":"D\u2019Amico","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Endoscopy I, IRCCS San Raffaele Hospital and Vita-Salute San Raffaele University, 20132 Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,3,21]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"2769","DOI":"10.1016\/S0140-6736(17)32448-0","article-title":"Worldwide incidence and prevalence of inflammatory bowel disease in the 21st century: A systematic review of population-based studies","volume":"390","author":"Ng","year":"2017","journal-title":"Lancet"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"1570","DOI":"10.1053\/j.gastro.2020.12.031","article-title":"STRIDE-II: An Update on the Selecting Therapeutic Targets in Inflammatory Bowel Disease (STRIDE) Initiative of the International Organization for the Study of IBD (IOIBD): Determining Therapeutic Goals for Treat-to-Target strategies in IBD","volume":"160","author":"Turner","year":"2021","journal-title":"Gastroenterology"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"55","DOI":"10.1080\/1744666X.2024.2400300","article-title":"Translational characterization of immune pathways in inflammatory bowel disease: Insights for targeted treatments","volume":"21","author":"Faggiani","year":"2025","journal-title":"Expert Rev. Clin. Immunol."},{"key":"ref_4","first-page":"771","article-title":"I-CARE, a European Prospective Cohort Study Assessing Safety and Effectiveness of Biologics in Inflammatory Bowel Disease","volume":"21","author":"Rahier","year":"2023","journal-title":"Clin. Gastroenterol. Hepatol. Off. Clin. Pract. J. Am. Gastroenterol. Assoc."},{"key":"ref_5","first-page":"855","article-title":"Safety of Immunosuppression in a Prospective Cohort of Inflammatory Bowel Disease Patients with a HIstoRy of CancEr: SAPPHIRE Registry","volume":"23","author":"Itzkowitz","year":"2024","journal-title":"Clin. Gastroenterol. Hepatol. Off. Clin. Pract. J. Am. Gastroenterol. Assoc."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"381","DOI":"10.1016\/j.semcancer.2008.10.002","article-title":"Immune escape by Epstein-Barr virus associated malignancies","volume":"18","author":"Moormann","year":"2008","journal-title":"Semin. Cancer Biol."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"1416","DOI":"10.1136\/gutjnl-2013-305763","article-title":"Risk of new or recurrent cancer under immunosuppressive therapy in patients with IBD and previous cancer","volume":"63","author":"Beaugerie","year":"2014","journal-title":"Gut"},{"key":"ref_8","first-page":"499","article-title":"Risk of Cancer Recurrence in Patients with Immune-Mediated Diseases with Use of Immunosuppressive Therapies: An Updated Systematic Review and Meta-Analysis","volume":"22","author":"Gupta","year":"2024","journal-title":"Clin. Gastroenterol. Hepatol. Off. Clin. Pract. J. Am. Gastroenterol. Assoc."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"1531","DOI":"10.1093\/ecco-jcc\/jjae091","article-title":"ECCO Guidelines on Therapeutics in Crohn\u2019s Disease: Medical Treatment","volume":"18","author":"Gordon","year":"2024","journal-title":"J. Crohn\u2019s Colitis"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"2","DOI":"10.1093\/ecco-jcc\/jjab178","article-title":"ECCO Guidelines on Therapeutics in Ulcerative Colitis: Medical Treatment","volume":"16","author":"Raine","year":"2022","journal-title":"J. Crohn\u2019s Colitis"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"827","DOI":"10.1093\/ecco-jcc\/jjac187","article-title":"ECCO Guidelines on Inflammatory Bowel Disease and Malignancies","volume":"17","author":"Gordon","year":"2023","journal-title":"J. Crohn\u2019s Colitis"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"97","DOI":"10.1053\/j.gastro.2016.03.037","article-title":"Cancer Recurrence Following Immune-Suppressive Therapies in Patients with Immune-Mediated Diseases: A Systematic Review and Meta-analysis","volume":"151","author":"Shelton","year":"2016","journal-title":"Gastroenterology"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"771","DOI":"10.14309\/ajg.0000000000000210","article-title":"Immunomodulatory Therapy Does Not Increase the Risk of Cancer in Persons with Inflammatory Bowel Disease and a History of Extracolonic Cancers","volume":"114","author":"Chaparro","year":"2019","journal-title":"Am. J. Gastroenterol."},{"key":"ref_14","first-page":"58","article-title":"Risk of New or Recurrent Cancer in Patients with Inflammatory Bowel Disease and Previous Cancer Exposed to Immunosuppressive and Anti-Tumor Necrosis Factor Agents","volume":"14","author":"Axelrad","year":"2016","journal-title":"Clin. Gastroenterol. Hepatol. Off. Clin. Pract. J. Am. Gastroenterol. Assoc."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"e1","DOI":"10.1097\/MCG.0000000000000865","article-title":"Risk of Cancer Recurrence Among Individuals Exposed to Antitumor Necrosis Factor Therapy: A Systematic Review and Meta-Analysis of Observational Studies","volume":"53","author":"Micic","year":"2019","journal-title":"J. Clin. Gastroenterol."},{"key":"ref_16","first-page":"88","article-title":"Vedolizumab or Tumor Necrosis Factor Antagonist Use and Risk of New or Recurrent Cancer in Patients with Inflammatory Bowel Disease with Prior Malignancy: A Retrospective Cohort Study","volume":"20","author":"Vedamurthy","year":"2022","journal-title":"Clin. Gastroenterol. Hepatol. Off. Clin. Pract. J. Am. Gastroenterol. Assoc."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"1246","DOI":"10.14309\/ajg.0000000000000679","article-title":"Repeated Occurrences of Basal Cell Cancer in Patients with Inflammatory Bowel Disease Treated with Immunosuppressive Medications","volume":"115","author":"Khan","year":"2020","journal-title":"Am. J. Gastroenterol."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"1598","DOI":"10.1016\/j.cgh.2023.01.002","article-title":"Comparative Safety of Biologic Agents in Patients with Inflammatory Bowel Disease with Active or Recent Malignancy: A Multi-Center Cohort Study","volume":"21","author":"Holmer","year":"2023","journal-title":"Clin. Gastroenterol. Hepatol."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"1826","DOI":"10.1093\/ibd\/izac035","article-title":"Ustekinumab and Vedolizumab Are Not Associated with Subsequent Cancer in IBD Patients with Prior Malignancy","volume":"28","author":"Hong","year":"2022","journal-title":"Inflamm. Bowel Dis."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"1523","DOI":"10.1093\/ecco-jcc\/jjac061","article-title":"Comparative Risk of Incident Cancer in Patients with Inflammatory Bowel Disease with Prior Non-digestive Malignancy According to Immunomodulator: A Multicentre Cohort Study","volume":"16","author":"Poullenot","year":"2022","journal-title":"J. Crohn\u2019s Colitis"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"S215","DOI":"10.1093\/ecco-jcc\/jju027.395","article-title":"P278. Thiopurines and Anti-Tnfs in Patients with Inflammatory Bowel Disease and a Positive History of Cancer","volume":"9","author":"Onali","year":"2015","journal-title":"J. Crohns Colitis"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"1362","DOI":"10.1097\/MIB.0000000000000741","article-title":"Risk of Incident Cancer in Inflammatory Bowel Disease Patients Starting Anti-TNF Therapy While Having Recent Malignancy","volume":"22","author":"Poullenot","year":"2016","journal-title":"Inflamm. Bowel Dis."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"1016","DOI":"10.1111\/jgh.15806","article-title":"Ustekinumab does not increase risk of new or recurrent cancer in inflammatory bowel disease patients with prior malignancy","volume":"37","author":"Hasan","year":"2022","journal-title":"J. Gastroenterol. Hepatol."},{"key":"ref_24","unstructured":"European Medicines Agency (EMA) (2025, January 12). Janus Kinase Inhibitors (JAKi)-Referral. Available online: https:\/\/www.ema.europa.eu\/en\/medicines\/human\/referrals\/janus-kinase-inhibitors-jaki."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"316","DOI":"10.1056\/NEJMoa2109927","article-title":"Cardiovascular and Cancer Risk with Tofacitinib in Rheumatoid Arthritis","volume":"386","author":"Ytterberg","year":"2022","journal-title":"N. Engl. J. Med."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"4542","DOI":"10.1200\/JCO.2007.11.2136","article-title":"Tumor necrosis factor alpha as a new target for renal cell carcinoma: Two sequential phase II trials of infliximab at standard and high dose","volume":"25","author":"Harrison","year":"2007","journal-title":"J. Clin. Oncol. Off. J. Am. Soc. Clin. Oncol."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"234","DOI":"10.1016\/j.lungcan.2009.06.020","article-title":"A placebo-controlled, double-blind trial of infliximab for cancer-associated weight loss in elderly and\/or poor performance non-small cell lung cancer patients (N01C9)","volume":"68","author":"Jatoi","year":"2010","journal-title":"Lung Cancer"},{"key":"ref_28","first-page":"18","article-title":"A multicenter, phase II study of infliximab plus gemcitabine in pancreatic cancer cachexia","volume":"6","author":"Wiedenmann","year":"2008","journal-title":"J. Support. Oncol."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"4","DOI":"10.1136\/gutjnl-2018-316777","article-title":"Mechanism of action of vedolizumab: Do we really understand it?","volume":"68","author":"Rogler","year":"2019","journal-title":"Gut"},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"466","DOI":"10.1111\/bjd.20818","article-title":"Long-term safety of risankizumab from 17 clinical trials in patients with moderate-to-severe plaque psoriasis","volume":"186","author":"Gordon","year":"2022","journal-title":"Br. J. Dermatol."},{"key":"ref_31","unstructured":"EMA (2023, April 26). \u201cZeposia\u201d, European Medicines Agency. Available online: https:\/\/www.ema.europa.eu\/en\/medicines\/human\/EPAR\/zeposia."},{"key":"ref_32","unstructured":"Velsipity (2025, February 11). European Medicines Agency (EMA). Available online: https:\/\/www.ema.europa.eu\/en\/medicines\/human\/EPAR\/velsipity."},{"key":"ref_33","doi-asserted-by":"crossref","unstructured":"Fanizza, J., Bencardino, S., Allocca, M., Furfaro, F., Zilli, A., Parigi, T.L., Fiorino, G., Peyrin-Biroulet, L., Danese, S., and D\u2019amico, F. (2024). Inflammatory Bowel Disease and Colorectal Cancer. Cancers, 16.","DOI":"10.20944\/preprints202407.2568.v1"},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"109545","DOI":"10.1016\/j.intimp.2022.109545","article-title":"Combination therapy in inflammatory bowel disease: Current evidence and perspectives","volume":"114","author":"Dai","year":"2023","journal-title":"Int. Immunopharmacol."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"1319","DOI":"10.1016\/j.cgh.2017.05.035","article-title":"The TREAT Registry: Evolution of Knowledge From 1999 to 2017: Lessons Learned","volume":"15","author":"Lichtenstein","year":"2017","journal-title":"Clin. Gastroenterol. Hepatol."},{"key":"ref_36","first-page":"680","article-title":"Five-year Safety Data from ENCORE, a European Observational Safety Registry for Adults with Crohn\u2019s Disease Treated with Infliximab [Remicade\u00ae] or Conventional Therapy","volume":"11","author":"Reinisch","year":"2017","journal-title":"J. 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