Integrated analysis of concomitant medications and oncological outcomes from PD-1/PD-L1 checkpoint inhibitors in clinical practice
| Autor: | Rita Chiari, Giampiero Porzio, Marco Tucci, Olga Nigro, Vincenzo Adamo, Cecilia Anesi, Mario Occhipinti, Michele De Tursi, Corrado Ficorella, Daniele Santini, Andrea Botticelli, Serena Macrini, Francesca Rastelli, Sergio Bracarda, Raffaele Giusti, Linda Nicolardi, Luigia Stefania Stucci, Paolo A. Ascierto, Riccardo Marconcini, Alessandro Inno, Enzo Veltri, Alessandro Russo, Francesco Spagnolo, Enrica Teresa Tanda, Alessio Cortellini, Marco Russano, Claudia Bareggi, Federica Zoratto, Alain Gelibter, Laura Pala, David J. Pinato, Domenico Mallardo, Marco Filetti, Nicola Petragnani, Alessandro Tuzi, R. Bisonni, Maria Giuseppa Vitale, Maria Grazia Vitale, Paolo Marchetti, Barbara Di Cocco |
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| Rok vydání: | 2020 |
| Předmět: |
Adult
Male 0301 basic medicine Cancer Research medicine.medical_specialty immunotherapy medications oncological outcomes medicine.drug_class Immunology Proton-pump inhibitor Pembrolizumab Young Adult 03 medical and health sciences 0302 clinical medicine Atezolizumab Internal medicine Humans Immunology and Allergy Medicine Progression-free survival Immune Checkpoint Inhibitors Aged Retrospective Studies Clinical/Translational Cancer Immunotherapy Aged 80 and over Pharmacology Aspirin Performance status business.industry Middle Aged 030104 developmental biology Oncology 030220 oncology & carcinogenesis Concomitant Molecular Medicine Female Nivolumab business medicine.drug |
| Zdroj: | Journal for Immunotherapy of Cancer |
| ISSN: | 2051-1426 |
| Popis: | BackgroundConcomitant medications, such as steroids, proton pump inhibitors (PPI) and antibiotics, might affect clinical outcomes with immune checkpoint inhibitors.MethodsWe conducted a multicenter observational retrospective study aimed at evaluating the impact of concomitant medications on clinical outcomes, by weighing their associations with baseline clinical characteristics (including performance status, burden of disease and body mass index) and the underlying causes for their prescription. This analysis included consecutive stage IV patients with cancer, who underwent treatment with single agent antiprogrammed death-1/programmed death ligand-1 (PD-1/PD-L1) with standard doses and schedules at the medical oncology departments of 20 Italian institutions. Each medication taken at the immunotherapy initiation was screened and collected into key categories as follows: corticosteroids, antibiotics, gastric acid suppressants (including proton pump inhibitors - PPIs), statins and other lipid-lowering agents, aspirin, anticoagulants, non-steroidal anti-inflammatory drugs (NSAIDs), ACE inhibitors/Angiotensin II receptor blockers, calcium antagonists, β-blockers, metformin and other oral antidiabetics, opioids.ResultsFrom June 2014 to March 2020, 1012 patients were included in the analysis. Primary tumors were: non-small cell lung cancer (52.2%), melanoma (26%), renal cell carcinoma (18.3%) and others (3.6%). Baseline statins (HR 1.60 (95% CI 1.14 to 2.25), p=0.0064), aspirin (HR 1.47 (95% CI 1.04 to 2.08, p=0.0267) and β-blockers (HR 1.76 (95% CI 1.16 to 2.69), p=0.0080) were confirmed to be independently related to an increased objective response rate. Patients receiving cancer-related steroids (HR 1.72 (95% CI 1.43 to 2.07), pConclusionWe confirmed the association between baseline steroids administered for cancer-related indication, systemic antibiotics, PPIs and worse clinical outcomes with PD-1/PD-L1 checkpoint inhibitors, which can be assumed to have immune-modulating detrimental effects. |
| Databáze: | OpenAIRE |
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