Molecular mechanisms underlying rheumatoid arthritis and cancer development and treatment

Future Oncol. 2020 Mar;16(9):483-495. doi: 10.2217/fon-2019-0722. Epub 2020 Feb 26.


Given recent advances in cancer immune therapy, specifically use of checkpoint inhibitors, understanding the link between autoimmunity and cancer is essential. Rheumatoid arthritis (RA) affects about 1% of the population, and early diagnosis is key to prevent joint damage. Management consists of disease-modifying antirheumatic drugs that alter normal immunologic pathways, which could affect malignancy growth and survival. Prolonged immune dysregulation and the resulting inflammatory response associated with development of RA may also lead to increased cancer development risk. RA has long been associated with increased risk of non-Hodgkin's lymphoma [1] and further evidence supports relationship to lung cancer [2]. This review will address the mechanisms behind cancer development and progression in RA patients, biomarkers and assess cancer risk and early detection.

Keywords: cancer risk; checkpoint inhibitor; immune-related adverse event; rheumatoid arthritis.

Publication types

  • Review

MeSH terms

  • Antineoplastic Agents, Immunological / adverse effects
  • Antineoplastic Agents, Immunological / therapeutic use
  • Antirheumatic Agents / therapeutic use
  • Arthritis, Rheumatoid / drug therapy
  • Arthritis, Rheumatoid / etiology*
  • Arthritis, Rheumatoid / immunology
  • Biomarkers, Tumor / antagonists & inhibitors
  • Biomarkers, Tumor / metabolism
  • Disease Progression
  • Humans
  • Immunotherapy / adverse effects
  • Inflammation
  • Neoplasms / immunology
  • Neoplasms / pathology*
  • Neoplasms / therapy*
  • Risk


  • Antineoplastic Agents, Immunological
  • Antirheumatic Agents
  • Biomarkers, Tumor