Can You Take Kesimpta with a Cancer History?
No, Kesimpta (ofatumumab) is contraindicated in patients with active malignancies or a history of cancer. The prescribing information explicitly states it should not be used in those with active cancer, and caution is advised for anyone with a prior cancer diagnosis due to potential risks of malignancy recurrence or progression.[1]
Why the Restriction Exists
Kesimpta, a B-cell depleting monoclonal antibody for relapsing multiple sclerosis (MS), suppresses immune function, which may impair the body's ability to fight cancer cells. Clinical trials and post-marketing data show increased malignancy rates in patients on anti-CD20 therapies like Kesimpta, prompting the label warning.[1][2]
What Happens If You've Had Cancer Before?
Patients with a history of cancer must discuss with their doctor. The FDA label recommends avoiding Kesimpta if cancer was recent or aggressive (e.g., breast, lymphoma). For remote or low-risk cases (e.g., basal cell skin cancer >5 years ago), some neurologists weigh benefits against risks individually, but approval isn't guaranteed.[1][3] No large-scale studies specifically address long-term cancer survivors on Kesimpta.
Alternatives for MS Patients with Cancer History
- Ocrevus (ocrelizumab): Similar anti-CD20 but with comparable malignancy warnings; often avoided too.[2]
- Fingolimod (Gilenya) or Siponimod (Mayzent): Sphingosine modulators with less B-cell depletion; safer for some cancer histories per labels.[4]
- Teriflunomide (Aubagio) or Dimethyl Fumarate (Tecfidera): Oral options with milder immune effects and fewer cancer contraindications.[4]
Disease-modifying therapies (DMTs) vary; interferon betas or glatiramer acetate may be first-line for high-risk patients.[3]
What MS Patients with Cancer History Should Ask Their Doctor