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

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 Crohn’s 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 Crohn’s 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.