In what may be a myth, there exists a poorly founded notion among some physicians that allergic people may be more resistant to certain forms of cancer. This concept was initiated by a report of Cockroft et al. in 1979, which summarized a comparative survey of 392 patients with three types of malignancy and 303 controls and concluded that the patients with endodermal neoplasia (lung, gut, bladder, prostate) had lowered forms of allergic disease. The major weakness of the survey was that the sample sizes were too small to be significant. In two other notable surveys done in later years with larger patient populations, the results were largely either contrary to the earlier study or too variable to make definitive conclusion.
An in-depth analysis of the data concerning the occurrence of tumors among patients treated with omalizumab is especially pertinent. Malignancies were found in 20 of 4127 (0.5%) of patients exposed to anti-IgE compared to 5 of 2236 (0.2%) of patients exposed to placebo, which on the surface might cause concern. However, a further analysis found that the majority of the 20 cases occurred in an older patient population, which was not matched with controls, and that at least 5 of 20 had the same cancer before exposure to anti-IgE. The time of exposure to anti-IgE was too short for the tumors to be induced and to grow to the substantial sizes reported. The tumors found were of seemingly random distribution of ectodermal, endodermal, and mesodermal categories. These various observations have led a panel of hemoncologists in a preliminary, blinded analysis to suggest that there should be no concern for causation of malignancy by anti-IgE.
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