Ask the Expert Biologic treatment in patients with successfully treated skin cancer Linda Stein Gold, MD
May 6, 2008
Question:
I recently had a squamous cell carcinoma that was caused by too many PUVA treatments removed. Is there a biologic that would be safe for my very severe psoriasis, even though I have had skin cancer? I have been told that I have to wait at least 5 years until I can use any biologic.
Answer:
A history of basal cell carcinoma or nonmetastatic successfully treated squamous cell carcinoma is usually allowed for our biologics studies, including efalizumab and IL-12/23 agents. Studies with adalimumab did exclude skin cancers. The prescribing information for etanercept states no specific contraindication for patients with skin cancer.
I am comfortable treating patients with successfully treated skin cancer with biologic agents. It has been recommended that patients wait a minimum of 5 years before biologic therapy if they have a history of noncutaneous skin cancer. I usually do not use biologic agents in patients with any history of noncutaneous skin cancer.
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