Effectiveness of pembrolizumab in patients with urothelial carcinoma receiving proton pump inhibitors

Effects of PPIs use on clinical outcomes of urothelial cancer patients receiving immune checkpoint inhibitor therapy

“…We gathered 518 potentially eligible records and assessed their titles and abstracts to see if they were suitable for inclusion. We discovered that six articles ( Hopkins et al, 2020 ; Ruiz-Bañobre et al, 2021 ; Fukuokaya et al, 2022 ; Kunimitsu et al, 2022 ; Okuyama et al, 2022 ; Tomisaki et al, 2022 ) met our criteria for inclusion after carefully reading the full texts of 16 records. The studies on RCC by Peng et al (2022) , Mollica et al (2022) , Kostine et al (2021) only provided the results of univariate analysis, so they were excluded.…”

“…Six studies ( Hopkins et al, 2020 ; Ruiz-Bañobre et al, 2021 ; Fukuokaya et al, 2022 ; Kunimitsu et al, 2022 ; Okuyama et al, 2022 ; Tomisaki et al, 2022 ), involving 1980 participants (759 who received PPIs and 1221 who did not), explored the impact of concomitant PPI usage on adjusted PFS among UC cancers receiving ICI treatment. As shown in Figure 2A , there was no significant heterogeneity among studies (I 2 = 7.4%, p = 0.369), so a fixed-effects model was utilized.…”

“…\The meta-analysis of adjusted OS was performed on six studies ( Hopkins et al, 2020 ; Ruiz-Bañobre et al, 2021 ; Fukuokaya et al, 2022 ; Kunimitsu et al, 2022 ; Okuyama et al, 2022 ; Tomisaki et al, 2022 ) with a total of 1980 participants (759 with PPIs and 1221 without PPIs). Since there was no significant heterogeneity ( Figure 2B , I 2 = 37.4%, p = 0.157), we applied a fixed-effects model.…”

“…As shown in Figure 2C , the pooled meta-analysis for multivariable analysis of the ORR included three studies ( Hopkins et al, 2020 ; Ruiz-Bañobre et al, 2021 ; Fukuokaya et al, 2022 ) with 1706 urological cancer patients (611 with PPIs and 1095 without PPIs). No significant heterogeneity existed, so a fixed-effects model was implemented (I 2 = 47.0%, p = 0.151).…”

“…Besides, the pooled HR for adjusted OS also did not significantly differ in the sensitivity analysis. The overall HR ranged from 1.542 (95% CI: 1.317–1.805, after omitting Fukuokaya et al, 2022 ) to 1.730 (95% CI: 1.336–2.238, after omitting Hopkins et al, 2020 ) ( Figure 3B ). Similarly, the pooled OR for adjusted ORR was not significantly different in the sensitivity analysis.…”