Continued surveillance and potential new options 

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Regulatory authorities issued precautionary recommendations following the ORAL Surveillance trial, which demonstrated an elevated risk of cancer with tofacitinib, compared to TNF inhibitors (TNFi).¹ While these findings have influenced clinical guidance, there is still limited real-world evidence on malignancy risks associated with the janus kinase inhibitors (JAKi), and they remain part of the recommendations for rheumatoid arthritis (RA) from EULAR – The European Alliance of Associations for Rheumatology – although with the caveat that pertinent risk factors must be taken into account, with clinicians advised to consider age, smoking, and other key medical factors when intending to prescribe a JAKi.² But there remains a need for more evidence.   

Cancer cells have evolved numerous strategies to suppress immune cells like NK cells, even when these cancer cell are producing the immune boosting factor IL-15. An obvious solution is to supply cancer patients with drugs that trigger the IL-15 receptor on immune cells, however these approaches have proven too toxic for patients because they boosts the activity of immune cells in every tissue, not just in the tumour, resulting in severe side-effects.

Until now.

A team of researchers at Monash University and oNKo-Innate in Melbourne, Australia have found a gene that can be switched off in NK cells which makes them extremely sensitive to the body’s own IL-15, opening the way for the development of a new therapy to treat cancer.