MULTIPLE SCLEROSIS MSJ JOURNAL

Nesbitt, Cassie;Sanfilippo, Paul;Zhu, Chao;Ozakbas, Serkan;Jokubaitis, Vilija;et.al.
(2026) Multiple Sclerosis Journal — Vol. 32, n° 10, p. 1083-1097 (2026)

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  • Nesbitt, Cassieorcid-logoDepartment of Neuroscience, School of Translational Medicine, Monash University, Melbourne, VIC Australia; Department of Neurology, Alfred Hospital, Melbourne, VIC, Australia; Department of Neurology, University Hospital Geelong, Geelong, VIC, Australia
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  • Sanfilippo, PaulDepartment of Neuroscience, School of Translational Medicine, Monash University, Melbourne, VIC, Australia; Department of Neurology, Alfred Hospital, Melbourne, VIC, Australia
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  • Zhu, ChaoDepartment of Neuroscience, School of Translational Medicine, Monash University, Melbourne, VIC, Australia; Department of Neurology, Alfred Hospital, Melbourne, VIC, Australia
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  • Ozakbas, SerkanMedical Point Hospital, Izmir University of Economics, Izmir, Turkey; Multiple Sclerosis Research Association, Izmir, Turkey
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  • Jokubaitis, Vilijaorcid-logoDepartment of Neuroscience, School of Translational Medicine, Monash University, Melbourne, VIC, Australia; Department of Neurology, Alfred Hospital, Melbourne, VIC, Australia
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Abstract
<jats:sec> <jats:title>Background and objective:</jats:title> <jats:p>As more people with multiple sclerosis (MS) survive cancer, questions about MS management after cancer are increasingly relevant. This study aimed to describe post-cancer treatment patterns and MS outcomes in people with recorded chemotherapy exposure.</jats:p> </jats:sec> <jats:sec> <jats:title>Methods:</jats:title> <jats:p>Using MSBase, we identified people with MS with cancer and chemotherapy exposure. Time to first relapse and 6-month confirmed disability progression (CDP) were analysed using Cox models with disease-modifying therapy (DMT) as a time-varying covariate. Outcomes were contextualised using 1:2 propensity-matched MS controls without cancer or chemotherapy.</jats:p> </jats:sec> <jats:sec> <jats:title>Results:</jats:title> <jats:p> In total, 363 individuals were followed for 2.8 years (median) after cancer. Older age at cancer was associated with lower relapse hazard (hazard ratio (HR) = 0.96 per year, <jats:italic toggle="yes">p</jats:italic>  = 0.008), while DMT category was not. The DMT category was not associated with CDP. In matched analysis (256 vs. 505), relapse hazard was lower during the first year after cancer (HR = 0.30, <jats:italic toggle="yes">p</jats:italic>  = 0.015) with no difference thereafter; CDP risk was similar (HR = 1.13, <jats:italic toggle="yes">p</jats:italic>  = 0.60). </jats:p> </jats:sec> <jats:sec> <jats:title>Conclusion:</jats:title> <jats:p>Post-cancer DMT category was not associated with relapse or CDP. Lower first-year relapse hazard, together with lower relapse hazard at older age, may provide cautious reassurance regarding early post-cancer inflammatory activity in similar clinical contexts, although the drivers of the first-year signal remain uncertain.</jats:p> </jats:sec>
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Nesbitt, C., Sanfilippo, P., Zhu, C., Ozakbas, S., Prat, A., Girard, M., Duquette, P., Kalincik, T., Roos, I., Buzzard, K., Skibina, O., Foschi, M., Surcinelli, A., Lechner-Scott, J., Patti, F., Kermode, A. G., Fabis-Pedrini, M., Carroll, W. M., Hodgkinson, S., et al. (2026). MULTIPLE SCLEROSIS MSJ JOURNAL. Multiple Sclerosis Journal, 32(10), 1083-1097. https://doi.org/10.1177/13524585261460658 (Original work published 2026)