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   DIR Return to: NOVANTRONE (mitoxantrone)
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       #Post#: 1213--------------------------------------------------
       Mitoxantrone may raise colorectal cancer risk
   DIR By: agate
       Date: May 13, 2016, 7:05 pm
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       Novantrone (mitoxantrone) isn't used very often in MS, mainly
       because of possible cardiac complications and acute myeloid
       leukemia (AML). Now it seems that it may put patients at a
       greater risk for colorectal cancer.
       From Medical News Today, May 12, 2016:
       --- Quote ---
       > MS drug may raise colorectal cancer risk
       >
       >
       > Written by Honor Whiteman
       >
       > For the first time, a new study suggests patients with
       multiple sclerosis who use the drug mitoxantrone may be at
       greater risk for colorectal cancer.
       >
       > The study suggests MS patients who use mitoxantrone are 10
       times more likely to develop colorectal cancer.
       > Furthermore, the study - published in the journal Neurology -
       supports previous research that suggests the drug raises the
       risk of acute myeloid leukemia (AML).
       >
       > Mitoxantrone - brand name Novantrone - is a drug approved for
       the reduction of disease relapses among patients with aggressive
       multiple sclerosis (MS) who do not respond to other therapies.
       >
       > The drug works by suppressing the immune system, reducing the
       activity of T cells, B cells, and macrophages that are believed
       to promote the attack on myelin - the protective coating that
       surrounds nerves.
       >
       > However, Dr. Mathias Buttmann, of the University of Würzburg,
       Germany, and colleagues note that the use of mitoxantrone for MS
       is limited, primarily because previous research has suggested
       the drug raises the risk of heart problems and AML.
       >
       > For this latest study, the team further investigated the
       association between mitoxantrone and cancer.
       >
       >
       > Using medical records of patients treated at a German
       hospital-based MS center between 1994-2007, the researchers
       identified 676 individuals with MS who were treated with
       mitoxantrone.
       >
       > Over a median follow-up period of 8.7 years, 37 - 5.5 percent
       - of the patients developed cancer after using mitoxantrone,
       including breast cancer, colorectal cancer, and AML.
       >
       > On comparing cancer incidence among these patients with the
       general population of Germany, the researchers found that
       patients with MS treated with mitoxantrone were at 10 times
       greater risk of AML.
       >
       > The rate of colorectal cancer was found to be three times
       higher among mitoxantrone-treated patients than the general
       population - an association that had not been identified
       previously.
       >
       > The rate of breast cancer and other cancer types was no higher
       for patients treated with mitoxantrone than the general
       population, the researchers report.
       >
       > Cancer risk 'acceptably low to justify mitoxantrone use' in
       severe cases
       >
       > Of four patients treated with mitoxantrone who developed AML,
       three were treated successfully and were alive at the end of
       follow-up.
       >
       > Of the seven mitoxantrone-treated patients who developed
       colorectal cancer, three died during follow-up. The researchers
       say this indicates that colorectal cancer is more
       life-threatening for MS patients treated with mitoxantrone than
       AML.
       >
       > Older age at first use of mitoxantrone was found to be a risk
       factor for cancer development. However, cumulative mitoxantrone
       dose and use of other drugs that suppress the immune system did
       not appear to affect cancer risk.
       >
       > While the findings clearly indicate an increased risk of AML
       and colorectal cancer with mitoxantrone use, the team says the
       overall cancer incidence in this cohort "appears acceptably low
       to justify mitoxantrone treatment in severely affected patients
       with MS if no better therapeutic alternative is available."
       >
       > "Mitoxantrone is the only approved treatment for people with
       secondary progressive MS without relapses and should be
       considered in people where the disease is evolving quickly.
       >
       > "Also, many of the new and highly effective MS drugs are not
       available to people in a number of countries for economic
       reasons, so mitoxantrone is being used for people with very
       active relapsing forms of the disease."
       >
       > Dr. Buttmann notes that their findings need to be confirmed in
       a larger study. If they are confirmed, he suggests that MS
       patients undergo colonoscopies following mitoxantrone use to
       screen for colorectal cancer.
       >
       >
       >
       >
       --- End Quote ---
       The article can be seen here
  HTML http://www.medicalnewstoday.com/articles/310121.php.
       #Post#: 1218--------------------------------------------------
       Re: Mitoxantrone may raise colorectal cancer risk
   DIR By: agate
       Date: May 17, 2016, 9:25 pm
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       This doesn't seem to add much information but there is another
       article about this in DocGuide Weekly, May 11, 2016:
       --- Quote ---
       > MS Drug Mitoxantrone Linked to Increased Risk of Colorectal
       Cancer
       >
       > The multiple sclerosis (MS) drug mitoxantrone may be
       associated with an increased risk of colorectal cancer,
       according to a study published in the May 11, 2016, online issue
       of the journal Neurology.
       >
       > Mitoxantrone is used for aggressive types of
       relapsing-remitting or progressive MS that do not respond to
       other MS drugs. But its use is limited because previous studies
       have shown an increased risk of leukaemia and heart damage.
       >
       > The current study examined whether the drug increases the risk
       of other types of cancer.
       >
       > Mathias Buttmann, MD, University of Würzburg, Würzburg,
       Germany, and colleagues looked at all people with MS who were
       treated with mitoxantrone from 1994 to 2007 and followed them
       until 2010.
       >
       > Of the 676 people, 37 people (5.5%) were diagnosed with cancer
       after taking the drug, including 9 people with breast cancer, 7
       with colorectal cancer, and 4 with acute myeloid leukaemia,
       which has been associated with mitoxantrone.
       >
       > The rate of leukaemia was 10 times higher in the people
       treated with mitoxantrone than in the general population in
       Germany. The rate of colorectal cancer was 3 times higher than
       that of the general population.
       >
       > For breast cancer and all other types of cancer, people who
       had taken mitoxantrone were no more likely to develop the
       diseases than those in the general population.
       >
       > Of the 7 people with colorectal cancer, 3 died from the cancer
       during the study. The 4 people with leukaemia all went into
       remission after treatment and were alive at the end of the
       study.
       >
       > The researchers also looked at whether factors such as how
       much of the drug people had received cumulatively and whether
       they also received other immunosuppressant drugs affected their
       risk of developing cancer. The only factor related to a higher
       risk of cancer was being older when starting to take the drug.
       >
       > “Despite an increased risk of acute myeloid leukaemia and
       colorectal cancer, the overall rate of cancer was low enough to
       justify still using this drug for people severely affected by MS
       if no better treatment is available,” said Dr. Buttmann.
       “Mitoxantrone is the only approved treatment for people with
       secondary progressive MS without relapses and should be
       considered in people where the disease is evolving quickly.
       Also, many of the new and highly effective MS drugs are not
       available to people in a number of countries for economic
       reasons, so mitoxantrone is being used for people with very
       active relapsing forms of the disease.”
       >
       > He noted that the study was relatively small and needs to be
       confirmed. If the results are confirmed, he said that
       colonoscopies should be given after treatment with the drug to
       screen for colorectal cancer, which can be treated more
       effectively when diagnosed earlier.
       >
       > SOURCE: American Academy of Neurology
       --- End Quote ---
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