Targeted therapies for psoriasis and atopic dermatitis in the context of malignancy: SPIN-FRT recommendations
In brief
Most biologic and oral therapies for psoriasis and eczema carry low cancer risk
A review of trial data and real-world studies finds that the overall incidence of new cancers is low for the majority of biologic and targeted oral agents used in psoriasis and atopic dermatitis, though risk may vary by drug class. Evidence remains sparse for patients with active or prior malignancy, highlighting important gaps for clinicians.
- Journal
- Journal of the European Academy of Dermatology and Venereology : JEADV (Q1)
- Published
- 10 August 2026
- Study design
- Randomized controlled trial
- Evidence level
- Level 1, High (CEBM 1b)
- Authors
- T Torres, N C Brembilla, B King, R Chovatiya, R B Warren, C Flohr, et al.
- PMID
- 42573454
- DOI
- 10.1111/jdv.70634
Why clinicians should know about it
- Picked for Dermatology (top studies of the week, 16 August 2026): Targeted therapies for psoriasis/AD with malignancy risk review
Abstract
BACKGROUND: The expanding use of biologic and oral targeted therapies has transformed the management of psoriasis and atopic dermatitis. These agents are increasingly prescribed to patients with current malignancy, a history of malignancy or an increased cancer risk, populations typically excluded from clinical trials. In the absence of robust long-term safety data, clinicians often rely on real-world evidence to inform treatment decisions. OBJECTIVES: To review the evidence regarding malignancy risk associated with biologic and oral targeted therapies used in psoriasis and atopic dermatitis and to provide expert consensus recommendations for patients with current malignancy, previous malignancy or increased risk of malignancy. METHODS: We describe the physiological roles of key immune pathways targeted in psoriasis and atopic dermatitis, as well as in cancer immunosurveillance, tumour progression and immune escape. We then summarize evidence from randomized controlled trials regarding the risk of de novo malignancy, followed by a synthesis of real-world data addressing cancer recurrence and progression in patients treated with biologic and oral targeted therapies. RESULTS: Available evidence suggests that the overall malignancy risk associated with most biologic and oral targeted therapies used in psoriasis and atopic dermatitis is low, although differences between therapeutic classes may exist. Real-world data remain limited for several therapeutic classes and in patients with active or previous malignancy. CONCLUSIONS: Based on the available evidence, we present consensus-based recommendations developed by a multidisciplinary expert panel convened by the Skin Inflammation & Psoriasis International Network-Fondation René Touraine (SPIN-FRT). These recommendations aim to support treatment decisions by balancing disease control with potential cancer-related risks while highlighting key evidence gaps.
Abstract as published, via PubMed.
For healthcare professionals. The summary is generated by AI from the published abstract, and the evidence level is assigned automatically from the study design on the Oxford CEBM hierarchy. Neither is medical advice. Read the full paper before changing practice.