Expert Consensus Addresses Malignancy Risk With Targeted Therapies for Psoriasis, Atopic Dermatitis

Available evidence suggests that most biologic and oral targeted therapies used to treat psoriasis and atopic dermatitis carry a low overall malignancy risk, although evidence remains limited for certain therapeutic classes and patients with active or previous cancer.

Investigators reviewed evidence on malignancy risk associated with targeted therapies and developed expert consensus recommendations to guide treatment decisions for patients with current malignancy, a history of malignancy, or an increased cancer risk.

The growing use of biologic and oral targeted therapies has expanded treatment options for psoriasis and atopic dermatitis, including among patients with cancer-related risks. However, these populations are typically excluded from clinical trials, leaving clinicians with limited long-term safety evidence when selecting therapies.

Researchers examined the physiological roles of immune pathways targeted by psoriasis and atopic dermatitis therapies, including their involvement in cancer immunosurveillance, tumor progression, and immune escape. The review incorporated randomized controlled trial evidence evaluating de novo malignancy risk and real-world data examining cancer recurrence and progression among patients receiving targeted therapies.

“Available evidence suggests that the overall malignancy risk associated with most biologic and oral targeted therapies used in psoriasis and atopic dermatitis is low,” the investigators reported, while noting that differences may exist among therapeutic classes.

Evidence gaps remain, particularly for several treatment classes and among patients with active or previous malignancy. These limitations may complicate treatment decisions when clinicians must weigh effective control of inflammatory skin disease against potential cancer-related risks.

A multidisciplinary expert panel convened by the Skin Inflammation & Psoriasis International Network-Fondation René Touraine developed consensus recommendations based on the available evidence.

According to the investigators, the recommendations are intended to support clinical decision-making by “balancing disease control with potential cancer-related risks while highlighting key evidence gaps.”

Reference
Torres T, Brembilla NC, King B, et al. Targeted therapies for psoriasis and atopic dermatitis in the context of malignancy: SPIN-FRT recommendations. J Eur Acad Dermatol Venereol. Published online August 10, 2026. doi:10.1111/jdv.70634