TNF-? Inhibitor Treatment for Crohn�s Disease: Comparative Review of Post Therapy Malignancy between Infliximab and Adalimumab

Abstract

The association between chronic inflammatory disease and cancer has been well established through years of research. In corollary, progressive resistance to chimeric monoclonal antibodies has been reported in literature. The purpose of this investigation was to establish the overall trend of the chimeric monoclonal antibody (Infliximab) failure compared with human monoclonal antibody (Adalimumab). It was opined that this failure may result in subclinical yet cancer-inducing inflammation that could be measurable in patient populations undergoing the therapy by examining cancer prevalence. An overall trend of increased incidence of new malignancy in patient populations on Infliximab compared with Adalimumab was confirmed from the literature reviewed. There was also a significant trend of developing Gastrointestinal (GI) related cancer in patients on Infliximab, which corresponds with the majority of the progression process in Crohns disease. It was opined that future observations in clinical practice will lead to the phasing out of Infliximab as a front-line monoclonal antibody in the treatment of Crohns disease in favor of less immunogenic monoclonal antibodies. In conclusion an increased incidence of both general and GI malignancies has been widely reported in patient populations undergoing Infliximab therapy than with Adalimumab.