Cancer Risk with JAK Inhibitors in Patients with Breast Cancer History

Clinical Considerations

• For patients with a history of breast cancer requiring treatment for inflammatory conditions, the European Society for Medical Oncology recommends considering alternative immunomodulatory therapies that do not carry the same malignancy risk profile 1
• If inflammatory disease is severe and refractory, consultation with both oncology and rheumatology is mandatory before considering any immunosuppressive therapy, as suggested by the European Society for Medical Oncology 2
• Patients with hormone receptor-positive breast cancer face additional theoretical concerns, as immune modulation may affect cancer surveillance mechanisms that prevent recurrence, according to the European Society for Medical Oncology 1, 2, 3, 4

Monitoring and Management

• Baseline and serial oncologic surveillance, including mammography and clinical breast examination at shortened intervals, is recommended for patients with a history of breast cancer who are being considered for alternative therapies, as advised by the European Society for Medical Oncology 1
• Multidisciplinary tumor board discussion involving medical oncology, rheumatology, and the patient is necessary for patients with a history of breast cancer who are being considered for alternative therapies, as recommended by the European Society for Medical Oncology 4
• Documented informed consent specifically addressing the increased cancer risk is required for patients with a history of breast cancer who are being considered for alternative therapies, as suggested by the European Society for Medical Oncology 1

Rinvoq Replacement in Breast Cancer Patients

Breast Cancer Treatment Considerations

• For patients on endocrine therapy, the American Society of Clinical Oncology and the European Society for Medical Oncology recommend ensuring the alternative immunomodulatory agent does not have drug interactions or compromise cancer treatment efficacy, with a moderate level of evidence 5, 6
• For patients receiving HER2-targeted therapy, the National Comprehensive Cancer Network suggests coordinating timing and monitoring with the oncology team, with a high level of evidence 7, 8