PMID- 37676282 OWN - NLM STAT- MEDLINE DCOM- 20231023 LR - 20240426 IS - 1432-0851 (Electronic) IS - 0340-7004 (Print) IS - 0340-7004 (Linking) VI - 72 IP - 11 DP - 2023 Nov TI - Use of concomitant proton pump inhibitors, statins or metformin in patients treated with pembrolizumab for metastatic urothelial carcinoma: data from the ARON-2 retrospective study. PG - 3665-3682 LID - 10.1007/s00262-023-03518-z [doi] AB - BACKGROUND: Concomitant medications may potentially affect the outcome of cancer patients. In this sub-analysis of the ARON-2 real-world study (NCT05290038), we aimed to assess the impact of concomitant use of proton pump inhibitors (PPI), statins, or metformin on outcome of patients with metastatic urothelial cancer (mUC) receiving second-line pembrolizumab. METHODS: We collected data from the hospital medical records of patients with mUC treated with pembrolizumab as second-line therapy at 87 institutions from 22 countries. Patients were assessed for overall survival (OS), progression-free survival (PFS), and overall response rate. We carried out a survival analysis by a Cox regression model. RESULTS: A total of 802 patients were eligible for this retrospective study; the median follow-up time was 15.3 months. PPI users compared to non-users showed inferior PFS (4.5 vs. 7.2 months, p = 0.002) and OS (8.7 vs. 14.1 months, p < 0.001). Concomitant PPI use remained a significant predictor of PFS and OS after multivariate Cox analysis. The use of statins or metformin was not associated with response or survival. CONCLUSIONS: Our study results suggest a significant prognostic impact of concomitant PPI use in mUC patients receiving pembrolizumab in the real-world context. The mechanism of this interaction warrants further elucidation. CI - (c) 2023. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature. FAU - Fiala, Ondrej AU - Fiala O AD - Department of Oncology and Radiotherapeutics, Faculty of Medicine and University Hospital Pilsen, Charles University, Alej Svobody 80, 304 60, Pilsen, Czech Republic. fialao@fnplzen.cz. AD - Biomedical Center, Faculty of Medicine in Pilsen, Charles University, Pilsen, Czech Republic. fialao@fnplzen.cz. FAU - Buti, Sebastiano AU - Buti S AD - Department of Medicine and Surgery, University Hospital of Parma, Parma, Italy. AD - Medical Oncology Unit, University Hospital of Parma, Parma, Italy. FAU - Takeshita, Hideki AU - Takeshita H AD - Department of Urology, Saitama Medical Center, Saitama Medical University, Saitama, Japan. FAU - Okada, Yohei AU - Okada Y AD - Department of Urology, Saitama Medical Center, Saitama Medical University, Saitama, Japan. FAU - Massari, Francesco AU - Massari F AD - Medical Oncology, IRCCS Azienda Ospedaliero-Universitaria Di Bologna, Via Albertoni - 15, Bologna, Italy. 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FAU - Santoni, Matteo AU - Santoni M AD - Oncology Unit, Macerata Hospital, Via Santa Lucia 2, 62100, Macerata, Italy. LA - eng PT - Journal Article DEP - 20230907 PL - Germany TA - Cancer Immunol Immunother JT - Cancer immunology, immunotherapy : CII JID - 8605732 RN - 0 (Proton Pump Inhibitors) RN - 0 (Hydroxymethylglutaryl-CoA Reductase Inhibitors) RN - 9100L32L2N (Metformin) RN - DPT0O3T46P (pembrolizumab) SB - IM MH - Humans MH - Proton Pump Inhibitors MH - *Hydroxymethylglutaryl-CoA Reductase Inhibitors/therapeutic use MH - *Metformin/therapeutic use MH - *Carcinoma, Transitional Cell MH - Retrospective Studies MH - *Urinary Bladder Neoplasms PMC - PMC10992198 OTO - NOTNLM OT - ARON-2 study OT - Immunotherapy OT - Metformin OT - Proton pump inhibitors OT - Statins OT - Urothelial cancer COIS- O. Fiala received honoraria from Roche, Janssen, GSK and Pfizer for consultations and lectures unrelated to this project. S. Buti received honoraria as speaker at scientific events and advisory role by BMS, Pfizer, MSD, Ipsen, AstraZeneca, Merck, all unrelated to this project. M. Santoni has received research support and honoraria from Janssen, Bristol Myers Squibb, Ipsen, MSD, Astellas and Bayer, all unrelated to this project. R. Kanesvaran has received fees for speaker bureau and advisory board activities from the following companies; Pfizer, MSD, BMS, Eisai, Ipsen, Johnson and Johnson, Merck, Amgen, Astellas and Bayer, all unrelated to this project. E. Grande has received honoraria for speaker engagements, advisory roles or funding of continuous medical education from Adacap, AMGEN, Angelini, Astellas, Astra Zeneca, Bayer, Blueprint, Bristol Myers Squibb, Caris Life Sciences, Celgene, Clovis-Oncology, Eisai, Eusa Pharma, Genetracer, Guardant Health, HRA-Pharma, IPSEN, ITM-Radiopharma, Janssen, Lexicon, Lilly, Merck KGaA, MSD, Nanostring Technologies, Natera, Novartis, ONCODNA (Biosequence), Palex, Pharmamar, Pierre Fabre, Pfizer, Roche, Sanofi-Genzyme, Servier, Taiho, and Thermo Fisher Scientific and has received research grants from Pfizer, Astra Zeneca, Astellas, and Lexicon Pharmaceuticals, all unrelated to this project. F. S. M. Monteiro has received research support from Janssen, Merck Sharp Dome and honoraria from Janssen, Ipsen, Bristol Myers Squibb and Merck Sharp Dome, all unrelated to this project. C. Porta has received honoraria from Angelini Pharma, Astra Zeneca, BMS, Eisai, General Electric, Ipsen and MSD and acted as a Protocol Steering Committee Member for BMS, Eisai and MSD, all unrelated to this project. Z. Myint has received research support from Merck unrelated to this project. J. Molina-Cerrillo declares consultant, advisory or speaker roles for IPSEN, Roche, Pfizer, Sanofi, Janssen, and BMS and has received research grants from Pfizer, IPSEN and Roche, all unrelated to this project. P. Giannatempo has received research support from Ipsen, Astra Zeneca, MSD and honoraria for speaker engagements, advisory roles from Astellas, MSD, Janssen, Pfizer, all unrelated to this project. E. T. Lam has received institutional research funding from Merck Sharp & Dohme Corp., a subsidiary of Merck & Co., Inc., Kenilworth, NJ, USA, Bristol-Myers Squibb, Pfizer, and F. Hoffmann-La Roche Ltd. The other authors declare to have no conflicts of interest. EDAT- 2023/09/07 12:42 MHDA- 2023/10/23 00:42 PMCR- 2023/09/07 CRDT- 2023/09/07 11:04 PHST- 2023/05/04 00:00 [received] PHST- 2023/08/03 00:00 [accepted] PHST- 2023/10/23 00:42 [medline] PHST- 2023/09/07 12:42 [pubmed] PHST- 2023/09/07 11:04 [entrez] PHST- 2023/09/07 00:00 [pmc-release] AID - 10.1007/s00262-023-03518-z [pii] AID - 3518 [pii] AID - 10.1007/s00262-023-03518-z [doi] PST - ppublish SO - Cancer Immunol Immunother. 2023 Nov;72(11):3665-3682. doi: 10.1007/s00262-023-03518-z. Epub 2023 Sep 7.