PMID- 36266366 OWN - NLM STAT- MEDLINE DCOM- 20221114 LR - 20221114 IS - 1432-1041 (Electronic) IS - 0031-6970 (Linking) VI - 78 IP - 12 DP - 2022 Dec TI - Clinical outcomes of concomitant use of proton pump inhibitors and regorafenib in patients with metastatic colorectal cancer: a multicenter study. PG - 1973-1979 LID - 10.1007/s00228-022-03403-1 [doi] AB - AIM: To compare survival outcomes, response rates, and adverse events (AEs) in proton pump inhibitor (PPI) user and non-user patients with metastatic colorectal cancer (mCRC) treated with regorafenib. METHODS: We included 272 patients with mCRC treated with regorafenib in this study. Patients were divided into two categories according to their status of PPI use. The primary endpoint was overall survival (OS). The secondary endpoints were time to treatment failure (TTF), response rates, and safety. To exclude immortal time bias in survival analyses, we compared PPI non-user patients and all patients. RESULTS: There were 141 and 131 patients in the PPI non-user and user groups. Baseline characteristics were similar in each group. Pantoprazole was the most used PPI. At the median 35.2 (95% confidence interval (CI): 32.6-37.9) months follow-up, the median OS was similar in PPI non-user and all patients (6.9 months (95% CI: 5.3-8.5) and 7.7 months (95% CI:6.6-8.8), p = 0.913). TTF was also similar in PPI non-user and all patients (3.3 months (95% CI: 2.7-3.9) and 3.5 months (95% CI: 3.0-4.0), p = 0.661). In multivariable analysis, no statistically significant difference was observed between PPI user and non-user groups in OS and TTF (hazard ratio (HR), 0.99; 95% CI, 0.77-1.28; p = 0.963 for OS; HR, 0.93; 0.77-1.20, p = 0.598 for TTF). The objective response rates (ORR) were similar in the PPI non-user and user groups (19.8% and 16.8%, p = 0.455). The rates of any grade AEs were also similar in each group. CONCLUSION: This study found no worse outcome in the combined use of PPI and regorafenib among patients with mCRC. CI - (c) 2022. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature. FAU - Yekeduz, Emre AU - Yekeduz E AD - Department of Medical Oncology, Faculty of Medicine, Ankara University, 06590, Ankara, Turkey. emreyekeduz@gmail.com. AD - Cancer Research Institute, Ankara University, Ankara, Turkey. emreyekeduz@gmail.com. FAU - Ozbay, Mehmet Fatih AU - Ozbay MF AD - Department of Medical Oncology, Faculty of Medicine, Akdeniz University, Antalya, Turkey. FAU - Caglayan, Dilek AU - Caglayan D AD - Department of Medical Oncology, Meram Faculty of Medicine, Necmettin Erbakan University, Konya, Turkey. FAU - Yildirim, Atila AU - Yildirim A AD - Department of Medical Oncology, Faculty of Medicine, Karadeniz Technical University, Trabzon, Turkey. FAU - Erol, Cihan AU - Erol C AD - Department of Medical Oncology, University Faculty of Medicine, Faculty of Medicine Ankara, Ankara Yildirim Beyazit University, Ankara, Turkey. FAU - Yildirim, Hasan Cagri AU - Yildirim HC AD - Department of Medical Oncology, Faculty of Medicine, Hacettepe University, Ankara, Turkey. FAU - Tunc, Sezai AU - Tunc S AD - Department of Medical Oncology, Faculty of Medicine, Dicle University, Diyarbakir, Turkey. FAU - Ozyurt, Neslihan AU - Ozyurt N AD - Medical Oncology Clinic, Prof. Dr. Ilhan Ozdemir State Hospital, Giresun, Turkey. FAU - Ozdemir, Feyyaz AU - Ozdemir F AD - Department of Medical Oncology, Faculty of Medicine, Karadeniz Technical University, Trabzon, Turkey. FAU - Sendur, Mehmet Ali Nahit AU - Sendur MAN AD - Department of Medical Oncology, University Faculty of Medicine, Faculty of Medicine Ankara, Ankara Yildirim Beyazit University, Ankara, Turkey. FAU - Isikdogan, Abdurrahman AU - Isikdogan A AD - Department of Medical Oncology, Faculty of Medicine, Dicle University, Diyarbakir, Turkey. FAU - Kilickap, Saadettin AU - Kilickap S AD - Department of Medical Oncology, Faculty of Medicine, Hacettepe University, Ankara, Turkey. AD - Faculty of Medicine, Liv Hospital Medical Oncology Clinic, Istinye University, Ankara, Turkey. FAU - Urun, Yuksel AU - Urun Y AD - Department of Medical Oncology, Faculty of Medicine, Ankara University, 06590, Ankara, Turkey. AD - Cancer Research Institute, Ankara University, Ankara, Turkey. FAU - Yalcin, Suayib AU - Yalcin S AD - Department of Medical Oncology, Faculty of Medicine, Hacettepe University, Ankara, Turkey. FAU - Artac, Mehmet AU - Artac M AD - Department of Medical Oncology, Meram Faculty of Medicine, Necmettin Erbakan University, Konya, Turkey. FAU - Coskun, Hasan Senol AU - Coskun HS AD - Department of Medical Oncology, Faculty of Medicine, Akdeniz University, Antalya, Turkey. FAU - Utkan, Gungor AU - Utkan G AD - Department of Medical Oncology, Faculty of Medicine, Ankara University, 06590, Ankara, Turkey. AD - Cancer Research Institute, Ankara University, Ankara, Turkey. LA - eng PT - Journal Article PT - Multicenter Study DEP - 20221021 PL - Germany TA - Eur J Clin Pharmacol JT - European journal of clinical pharmacology JID - 1256165 RN - 24T2A1DOYB (regorafenib) RN - 0 (Proton Pump Inhibitors) RN - 0 (Phenylurea Compounds) SB - IM MH - Humans MH - Proton Pump Inhibitors/adverse effects MH - *Colorectal Neoplasms/drug therapy/pathology MH - Survival Rate MH - Phenylurea Compounds/adverse effects MH - *Rectal Neoplasms/drug therapy OTO - NOTNLM OT - Acid suppression OT - Drug-drug interactions OT - Regorafenib EDAT- 2022/10/21 06:00 MHDA- 2022/11/15 06:00 CRDT- 2022/10/20 23:32 PHST- 2022/08/04 00:00 [received] PHST- 2022/10/10 00:00 [accepted] PHST- 2022/10/21 06:00 [pubmed] PHST- 2022/11/15 06:00 [medline] PHST- 2022/10/20 23:32 [entrez] AID - 10.1007/s00228-022-03403-1 [pii] AID - 10.1007/s00228-022-03403-1 [doi] PST - ppublish SO - Eur J Clin Pharmacol. 2022 Dec;78(12):1973-1979. doi: 10.1007/s00228-022-03403-1. Epub 2022 Oct 21.