Proton Pump Inhibitor (Ppis) Therapy May Impair Capecitabine (Cape) Efficacy in Metastatic Gastroesophageal Cancer (Gec), Results from the Trio-013/Logic Trial

Chu, M.P.; Hecht, J. Randolph; Slamon, Dennis J.; Fontaine, Amélie; King, Kathryn M.; Koski, Sheryl; Mulder, Karen; Hiller, Julie Price; Scarfe, Andrew; Spratlin, Jennifer L.; Bang, Y-J.; Hoff, Paulo M.; Sobrero, A.; Qin, Shuqi; Afenjar, Karen; Houé, Vincent; Huang, Yudai; Khan-Wasti, S.; Sawyer, Michael

doi:10.1093/annonc/mdu334.6

Cited by 1 publication

(1 citation statement)

References 0 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The observation that diuretic use was associated with worse clinical outcomes is consistent with a recent population-based study involving 3,967 CRC patients, showing a statistically significant increase in death risk with thiazide diuretics use [ 15 ]. Also, recent studies in gastroesophageal and non-small-cell lung cancer demonstrated that PPI use negatively impacted the efficacy of capecitabine plus oxaliplatin and erlotinib, respectively [ 16 , 17 ] suggesting that at least for oral drugs (e.g., capecitabine in our study), PPI use may be associated with altered absorption and reduced efficacy.…”

Section: Discussionmentioning

confidence: 64%

A Novel Computational Tool for Mining Real-Life Data: Application in the Metastatic Colorectal Cancer Care Setting

et al. 2016

View full text Add to dashboard Cite

BackgroundRandomized clinical trials constitute the gold-standard for evaluating new anti-cancer therapies; however, real-life data are key in complementing clinically useful information. We developed a computational tool for real-life data analysis and applied it to the metastatic colorectal cancer (mCRC) setting. This tool addressed the impact of oncology/non-oncology parameters on treatment patterns and clinical outcomes.MethodsThe developed tool enables extraction of any computerized information including comorbidities and use of drugs (oncological/non-oncological) per individual HMO member. The study in which we evaluated this tool was a retrospective cohort study that included Maccabi Healthcare Services members with mCRC receiving bevacizumab with fluoropyrimidines (FP), FP plus oxaliplatin (FP-O), or FP plus irinotecan (FP-I) in the first-line between 9/2006 and 12/2013.ResultsThe analysis included 753 patients of whom 15.4% underwent subsequent metastasectomy (the Surgery group). For the entire cohort, median overall survival (OS) was 20.5 months; in the Surgery group, median duration of bevacizumab-containing therapy (DOT) pre-surgery was 6.1 months; median OS was not reached. In the Non-surgery group, median OS and DOT were 18.7 and 11.4 months, respectively; no significant OS differences were noted between FP-O and FP-I, whereas FP use was associated with shorter OS (12.3 month; p <0.002; notably, these patients were older). Patients who received both FP-O- and FP-I-based regimens achieved numerically longer OS vs. those who received only one of these regimens (22.1 [19.9–24.0] vs. 18.9 [15.5–21.9] months). Among patients assessed for wild-type KRAS and treated with subsequent anti-EGFR agent, OS was 25.4 months and 18.7 months for 124 treated vs. 37 non-treated patients (non-significant). Cox analysis (controlling for age and gender) identified several non-oncology parameters associated with poorer clinical outcomes including concurrent use of diuretics and proton-pump inhibitors.ConclusionsOur tool provided insights that confirmed/complemented information gained from randomized-clinical trials. Prospective tool implementation is warranted.

show abstract

Section: Discussionmentioning

confidence: 64%