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Can gene expression help to pick the right biologic to treat psoriasis in cancer patients?

A study assessing gene expression in cancer patients revealed both benefit and harm for cancer prognosis from high or low TNF, IL-17A, and IL-23A expression. This conceptual approach may influence future management of dermatologic patients with malignancies [1].

Biologics like TNF blockers or inhibitors of IL-17A and IL-23 have started a new era of possible achievements in psoriasis treatment. However, there is a worrisome and ongoing discussion about an increased risk of cancer linked to psoriasis management with agents in these drug classes. “Clinicians and dermatologists often face difficult decisions in prescribing these drugs, especially to those who have a history of cancer or those who have a current active cancer,” said Dr Nikolai Klebanov (Brigham and Women’s Hospital, USA).

To gain further insight, a theoretical and hypothesis-generating, observational retrospective study was performed using The Cancer Genome Atlas (TCGA). Over 9,000 patie...



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