PD08-03 LONG-TERM TUMOR NECROSIS FACTOR-ALPHA INHIBITOR USE INCREASES THE RISK OF RENAL CELL CARCINOMA

Abstract

You have accessJournal of UrologyCME1 Apr 2023PD08-03 LONG-TERM TUMOR NECROSIS FACTOR-ALPHA INHIBITOR USE INCREASES THE RISK OF RENAL CELL CARCINOMA Conor Driscoll, Jordan Rich, Dylan Isaacson, Joseph Nicolas, Yu Jiang, Xinlei Mi, Christopher Yang, Victoria Kocsuta, Regine Goh, Niti Patel, Eric Li, Rashid Siddiqui, Travis Meyers, John Witte, Linda Kachuri, Hui Zhang, Molly Beestrum, Edward Schaeffer, and Shilajit Kundu Conor DriscollConor Driscoll More articles by this author , Jordan RichJordan Rich More articles by this author , Dylan IsaacsonDylan Isaacson More articles by this author , Joseph NicolasJoseph Nicolas More articles by this author , Yu JiangYu Jiang More articles by this author , Xinlei MiXinlei Mi More articles by this author , Christopher YangChristopher Yang More articles by this author , Victoria KocsutaVictoria Kocsuta More articles by this author , Regine GohRegine Goh More articles by this author , Niti PatelNiti Patel More articles by this author , Eric LiEric Li More articles by this author , Rashid SiddiquiRashid Siddiqui More articles by this author , Travis MeyersTravis Meyers More articles by this author , John WitteJohn Witte More articles by this author , Linda KachuriLinda Kachuri More articles by this author , Hui ZhangHui Zhang More articles by this author , Molly BeestrumMolly Beestrum More articles by this author , Edward SchaefferEdward Schaeffer More articles by this author , and Shilajit KunduShilajit Kundu More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003239.03AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Tumor necrosis factor-alpha inhibitors (TNF-I) are widely prescribed for chronic inflammatory conditions. Renal cell carcinoma (RCC) is known to be immune-responsive with the immune upregulation the mainstay of therapy for advanced disease. Prior studies of TNF-I use and malignancy risk with short follow-up have not demonstrated consistent associations outside non-melanoma skin cancers. We performed a broader, contemporary study of this potential relationship incorporating a large institutional cohort analysis. METHODS: This was a retrospective, unmatched-cohort study involving a single academic medical center and conducted from 1998 to 2022. 11,086 patients with TNF-I exposure for inflammatory conditions and 32,665 patients with inflammatory conditions without TNF-I exposure were identified. Cox proportional hazards regression analysis, adjusting for age, race, gender, smoking status and underlying inflammatory disease type, was performed. TNF-I exposure was considered a time-varying factor, as TNF-I induction date was not fixed for patients in the TNF-I-exposed group. Models were fit incorporating all patients who developed any malignancy during the study period and individually for each type of cancer. Results of regression models were presented as forest plots with hazard ratios and 95% confidence intervals. RESULTS: TNF-I exposure was associated with increased risk of any malignancy (HR=1.19, 95% CI 1.09-1.29, p<0.001). TNF-I exposure was positively associated with risk of RCC (HR 1.47, 95% CI 1.00-2.15, p=0.05). CONCLUSIONS: This increased risk of RCC in patients exposed to TNF-I suggests that this tumor microenvironment is potentially subject to TNF-mediated immune regulation and that patients on TNF-I may benefit from screening. Source of Funding: Polsky Urologic Cancer Institute, Northwestern University Feinberg School of Medicine © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e233 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Conor Driscoll More articles by this author Jordan Rich More articles by this author Dylan Isaacson More articles by this author Joseph Nicolas More articles by this author Yu Jiang More articles by this author Xinlei Mi More articles by this author Christopher Yang More articles by this author Victoria Kocsuta More articles by this author Regine Goh More articles by this author Niti Patel More articles by this author Eric Li More articles by this author Rashid Siddiqui More articles by this author Travis Meyers More articles by this author John Witte More articles by this author Linda Kachuri More articles by this author Hui Zhang More articles by this author Molly Beestrum More articles by this author Edward Schaeffer More articles by this author Shilajit Kundu More articles by this author Expand All Advertisement PDF downloadLoading ...