Would you consider continuing a biologic for difficult to control autoimmune disease in a patient with a recent diagnosis of a surgically curable solid malignancy?

There continues to be relative uncertainty regarding the management of biologic therapy in these patients. As treating physicians, this scenario is not uncommon where a decision to continue or stop a biologic has to be made in face of solid malignancy. A detailed review of individual circumstances taking into account patient preference, disease course, kind of malignancy, and timing of surgical intervention has to be done.

It is important to note that there are still fears that biologics may increase the chance for a malignancy recurrence or interfere with treatment or impair healing but the available evidence contradicts the above concerns.

So in this patient, I would feel comfortable with continuing the biologic treatment including a TNFi ...