PMID- 37937583
OWN - NLM
STAT- Publisher
LR  - 20231108
IS  - 1537-4513 (Electronic)
IS  - 1524-9557 (Linking)
DP  - 2023 Nov 6
TI  - Effect of Concomitant Use of Proton Pump Inhibitors on Immunotherapy Clinical 
      Response in Advanced Cancer Patients: Real-Life Setting.
LID - 10.1097/CJI.0000000000000494 [doi]
AB  - The alteration of the gut microbiota mediated by proton pump inhibitor (PPI) 
      drugs could be involved in the clinical response associated with immunotherapy 
      [immunocheckpoint inhibitors (ICIs)] in cancer patients. Due to the current 
      controversy in the scientific evidence, it has been proposed to evaluate the 
      correlation between the concomitant use of PPIs and the effectiveness of 
      immunotherapy in a real clinical practice setting. Single-center retrospective 
      cohort study that included patients treated with anti-PD-1 or anti-CTLA4, 
      including nivolumab, pembrolizumab, atezolizumab, or the combination 
      ipilimumab-nivolumab in metastatic neoplastic disease. The clinical effectiveness 
      of ICI, measured in progression-free survival (PFS) and overall survival (OS), 
      was compared between the PPI-use versus PPI-no-use group. PPI-use group was 
      associated with lower PFS [hazard ratio (HR):1.89 (1.38-2.59), P<0.001] and OS 
      [HR: 2.02 (1.45-2.82), P<0.001] versus PPI-no-use group. However, this difference 
      was not observed for pembrolizumab PFS [HR: 1.38 (0.93-2.39), P=0.160] and OS 
      [HR: 1.41 (0.81-2.44), P=0.187]. The study showed significantly lower PFS and OS 
      in the chronic PPI-use group (P<0.001), recent PPI-use group (P<0.001) and 
      concomitant PPI-use group (P=0.001, 0.007) versus PPI-no-use group. However, late 
      PPI use >30 days after the onset of ICI has no significant effect on the efficacy 
      of treatment [HR: 0.92 (0.49-1.70), P=0.791; HR: 1.10 (0.59-2.05), P=0.756]. The 
      concomitant use of PPIs in immunotherapy is associated with worse clinical 
      outcomes compared with the group without PPI use. In addition, the study shows 
      how the late use of PPIs does not have a significant effect on clinical benefit.
CI  - Copyright (c) 2023 Wolters Kluwer Health, Inc. All rights reserved.
FAU - Cantarelli, Lorenzo
AU  - Cantarelli L
AD  - Servicio de Farmacia, Hospital Nuestra Senora de Guadalupe, La Gomera, Spain.
FAU - Gutierrez Nicolas, Fernando
AU  - Gutierrez Nicolas F
AD  - Servicio de Farmacia, Complejo Hospitalario Universitario de Canarias, Tenerife, 
      Spain.
FAU - Garcia Gil, Sara
AU  - Garcia Gil S
AD  - Servicio de Farmacia, Complejo Hospitalario Universitario de Canarias, Tenerife, 
      Spain.
FAU - Morales Barrios, Jose A
AU  - Morales Barrios JA
AD  - Servicio de Farmacia, Complejo Hospitalario Universitario de Canarias, Tenerife, 
      Spain.
FAU - Oramas Rodriguez, Juana
AU  - Oramas Rodriguez J
AD  - Servicio de Oncologia medica, Complejo Hospitalario Universitario de Canarias, 
      Tenerife, Spain.
FAU - Nazco Casariego, Gloria J
AU  - Nazco Casariego GJ
AD  - Servicio de Farmacia, Complejo Hospitalario Universitario de Canarias, Tenerife, 
      Spain.
LA  - eng
PT  - Journal Article
DEP - 20231106
PL  - United States
TA  - J Immunother
JT  - Journal of immunotherapy (Hagerstown, Md. : 1997)
JID - 9706083
SB  - IM
EDAT- 2023/11/08 12:42
MHDA- 2023/11/08 12:42
CRDT- 2023/11/08 06:40
PHST- 2023/04/03 00:00 [received]
PHST- 2023/09/27 00:00 [accepted]
PHST- 2023/11/08 12:42 [medline]
PHST- 2023/11/08 12:42 [pubmed]
PHST- 2023/11/08 06:40 [entrez]
AID - 00002371-990000000-00074 [pii]
AID - 10.1097/CJI.0000000000000494 [doi]
PST - aheadofprint
SO  - J Immunother. 2023 Nov 6. doi: 10.1097/CJI.0000000000000494.