Expert Opin Pharmacother. 2026 Nov 13. doi: 10.1080/14656566.2026.2764546. Online ahead of print.
ABSTRACT
INTRODUCTION: The management of moderate-to-severe plaque psoriasis in patients with current or previous malignancy remains challenging because of concerns regarding cancer recurrence or progression and the limited representation of these patients in randomized trials.
AREAS COVERED: This narrative review examines systemic treatment of psoriasis in patients with remote, recent, or active malignancy and in those with immune checkpoint inhibitor-associated psoriasis. PubMed/MEDLINE, Embase, and Scopus were searched from database inception through August 2026 to identify relevant publications addressing systemic psoriasis treatment in patients with current or previous malignancy. Evidence on traditional systemic agents, apremilast, deucravacitinib, and biologics targeting TNF, IL-12/23, IL-17, and IL-23 was evaluated together with current guidelines, real-world studies, registries, and pharmacovigilance data.
EXPERT OPINION: Therapeutic decisions should move beyond rigid time-based restrictions and instead reflect individualized oncologic risk, psoriasis severity, treatment efficacy, and patient preferences within multidisciplinary dermatology-oncology care. Accumulating evidence is particularly reassuring for IL-17 and IL-23 inhibitors in patients with previous malignancy, while apremilast and acitretin remain useful non-biologic options. Evidence is more limited in active cancer and for deucravacitinib. In immune checkpoint inhibitor-associated psoriasis, effective systemic treatment can often be achieved without permanent interruption of anticancer therapy.
PMID:43021755 | DOI:10.1080/14656566.2026.2764546