P40.15 Proton Pump Inhibitors, Prior Therapy and Survival in Patients Treated With Immune Checkpoint Inhibitors for Advanced NSCLC

Husain, Marium; Xu, Menglin; Patel, Sandipkumar; Johns, Andrew; Grogan, Madison; Li, M.; Lopez, Gabrielle; Miah, Abdul; Hoyd, Rebecca; Liu, Y.; Muniak, Mitchell; Haddad, Tyler; Tinoco, Gabriel; Kendra, Kari; Presley, Carolyn J.; Spakowicz, Daniel; Owen, Dwight H.

doi:10.1016/j.jtho.2021.08.452

Cited by 1 publication

(5 citation statements)

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“…Twenty-four articles were excluded because they were reviews or meta-analyses (n=12), study protocols (n=1), editorials (n=1), and not available for necessary information (n=10). Finally, a total of 30 studies were included 15–17,24,39,40,42–61,65–68. The flowchart of study selection is shown in Figure 1.…”

Section: Resultsmentioning

confidence: 99%

“…Currently, the effect of concomitant antacid use on ICI efficacy is receiving increasing attention. However, because of many confounding factors and a small sample size, this problem remains unclear 15–17,24,39–61,66–68,74. Thus, we performed a systematic literature review and meta-analysis to clarify the association between antacids and ICIs.…”

Section: Discussionmentioning

confidence: 99%

“…Finally, a total of 30 studies were included. [15][16][17]24,39,40,[42][43][44][45][46][47][48][49][50][51][52][53][54][55][56][57][58][59][60][61][65][66][67][68] The flowchart of study selection is shown in Figure 1.…”

Section: Study Selectionmentioning

confidence: 99%

“…Some studies found that PPI use might diminish the efficacy of ICIs in advanced cancer patients, resulting in worse overall survival (OS). 15,17,24,[39][40][41][42][43][44][45][46][47][48][49][50][51] However, other studies indicated that PPI use was not associated with OS. 16,[52][53][54][55][56][57][58][59][60][61] Progression-free survival (PFS), objective response rate (ORR), and immune-related adverse events (irAEs) also remain conflicting among different studies.…”

mentioning

confidence: 99%

“…Recently, the effect of PPI use on the survival of advanced cancer patients has received attention. Some studies found that PPI use might diminish the efficacy of ICIs in advanced cancer patients, resulting in worse overall survival (OS) 15,17,24,39–51. However, other studies indicated that PPI use was not associated with OS 16,52–61.…”

mentioning

confidence: 99%

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Effect of Antacid Use on Immune Checkpoint Inhibitors in Advanced Solid Cancer Patients: A Systematic Review and Meta-analysis

Deng

Zhang

et al. 2022

Journal of Immunotherapy

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The influence of antacids use on immune checkpoint inhibitor (ICI) efficacy remains unclear. A systematic review and meta-analysis was performed to evaluate the effect of proton pump inhibitors (PPIs) and histamine-2-receptor antagonists (H2RAs) on ICI efficacy in advanced solid cancer patients. A systematic literature search in PubMed, EMBASE, and Web of Science was performed to retrieve studies investigating the effect of antacid use on ICI efficacy. Overall survival (OS), progressionfree survival (PFS), objective response rate (ORR), and immunerelated adverse events were measured using hazard ratios (HRs) or odds ratios (ORs). Thirty studies enrolling 16,147 advanced cancer patients receiving ICI treatment were included. The pooled analysis indicated that PPI use was associated with shorter OS (HR = 1.40, 95% CI, 1.25-1.57) and PFS (HR = 1.34, 95% CI, 1.19-1.52) in advanced cancer patients treated with ICIs. PPI use did not show effect on ORR or immune-related adverse event of advanced cancer patients receiving ICI treatment. OS, PFS, and ORR did not differ between H2RA users and non-H2RA users. In subgroup analyses, PPI use was associated with shorter OS and PFS in NSCLC and urothelial carcinoma patients and in patients treated with anti-programmed cell death 1 or anti-programmed cell death ligand 1 monotherapy. In addition, ICI efficacy was different in the antacid exposure time frame subgroups. In conclusion, PPI use has a negative effect on OS and PFS among advanced cancer patients receiving ICI treatment. PPIs should be cautiously administered among advanced cancer patients treated with ICI. The safety of H2RAs and the influence of H2RAs on ICI efficacy need further investigation.

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Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%