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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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