Biologic Therapy safe in Psoriasis Patients With Active or Recent Malignancy, suggests research

A new study published in the Journal of American Academy of Dermatology showed that biologic therapies were linked to cancer progression, recurrence, and infection outcomes in patients with psoriasis and current or recent malignancy that were similar to those observed with traditional systemic treatments, indicating a similar overall safety profile.

Given the known link between psoriasis and an increased risk of cancer, cancer has become a major worry as the incidence of psoriasis rises in older populations. Although targeted biologic treatments have been more widely used and diverse in recent years, their safety in patients with recent or ongoing cancer is still unknown, mostly because they are routinely excluded from research studies. This exclusion is supported by the possibility that immunomodulation may affect the growth or recurrence of tumors, and the danger of serious infections in a population that is already immunocompromised.

There is also no evidence-based advice available to doctors for treating psoriasis in this high-risk group because existing national and international recommendations recommend against starting biologic therapy in individuals who have had cancer within the previous five years. Thus, assessing the safety profile of biologic medicines in a sizable, real-world cohort of psoriasis patients with ongoing or recent cancer was the primary goal of this study.

333 people with psoriasis and either ongoing malignancy or a recent history of cancer were included in the surveillance research. Comparators were patients who had treatment with traditional systemic medicines. Coprimary outcomes were the incidence of severe infections and survival without progression or recurrence.

The progression/recurrence rates per 100 patient-years were 10.7 for biologics and 10.5 for conventional treatment after a median follow-up of 6 years. In both groups, the cumulative 1-year survival rate without progression or recurrence was 86% (P =.89). Overall, biologics did not affect cancer progression (hazard ratio, 1.02; 95% confidence interval, 0.59-1.77; P = .94).

Impaired functional status, advanced cancer stage (hazard ratio per stage increment, 1.48; 95% CI 1.21-1.82; P <.001), and increased comorbidity load were all predictors of progression or recurrence. Overall, these results suggest that biologics have a good safety record in cancer patients, and the degree of psoriasis may influence treatment decisions more so than the existence of cancer.

Source:

Bar, D., Brilant, L., Lidar, M., Barzilai, A., & Baum, S. (2025). Cancer progression, recurrence, and infection outcomes in psoriasis patients with active or recent malignancy treated with biologic therapy: A cohort study showing comparable safety to conventional agents. Journal of the American Academy of Dermatology. https://doi.org/10.1016/j.jaad.2025.12.039