Antacid exposure and immunotherapy outcomes among patients with advanced hepatocellular carcinoma.

Jun, Tomi; Ozbek, Umut; Dharmapuri, Sirish; Hardy-Abeloos, Camille; Zhu, Huili; Lin, Jung-Yi; Personeni, Nicola; Pressiani, Tiziana; Nishida, Naoshi; Lee, Pei-Chang; Lee, Chieh-Ju; Hildebrand, Hannah; Nimkar, Neil; Paul, Sonal; Fessas, Petros; Naeem, Muntaha; Bettinger, Dominik; Khan, Uqba; Saeed, Anwaar; Huang, Yi-Hsiang; Kudo, Masatoshi; Rimassa, Lorenza; Marron, Thomas U; Pinato, David J; Ang, Celina

Jun, Tomi; Ozbek, Umut; Dharmapuri, Sirish; Hardy-Abeloos, Camille; Zhu, Huili; Lin, Jung-Yi; Personeni, Nicola; Pressiani, Tiziana; Nishida, Naoshi; Lee, Pei-Chang; Lee, Chieh-Ju; Hildebrand, Hannah; Nimkar, Neil; Paul, Sonal; Fessas, Petros; Naeem, Muntaha; Bettinger, Dominik; Khan, Uqba; Saeed, Anwaar; Huang, Yi-Hsiang; Kudo, Masatoshi; Rimassa, Lorenza; Marron, Thomas U; Pinato, David J; Ang, Celina.

Afiliação

Jun T; Division of Hematology and Medical Oncology, Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
Ozbek U; Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
Dharmapuri S; Division of Hematology and Medical Oncology, Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
Hardy-Abeloos C; Icahn School of Medicine at Mount Sinai, New York, NY, USA.
Zhu H; Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
Lin JY; Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
Personeni N; Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan, Italy.
Pressiani T; Medical Oncology and Hematology Unit, Humanitas Cancer Center, IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy.
Nishida N; Department of Gastroenterology and Hepatology, Kindai University Faculty of Medicine, Osaka-Sayama, Osaka, Japan.
Lee PC; Division of Gastroenterology and Hepatology, Department of Medicine, Taipei.
Lee CJ; Division of Gastroenterology and Hepatology, Department of Medicine, Taipei.
Hildebrand H; Division of Medical Oncology, Department of Medicine, Kansas University Cancer Center, Westwood, KS, USA.
Nimkar N; New York Presbyterian Brooklyn Methodist Hospital, Brooklyn, NY, USA.
Paul S; New York Presbyterian Brooklyn Methodist Hospital, Brooklyn, NY, USA.
Fessas P; Department of Surgery and Cancer, Imperial College London, Hammersmith Hospital, London, UK.
Naeem M; Department of Surgery and Cancer, Imperial College London, Hammersmith Hospital, London, UK.
Bettinger D; Department of Medicine II, Faculty of Medicine, Medical Center University of Freiburg, University of Freiburg, Freiburg, Germany.
Khan U; Division of Hematology and Oncology, Weill Cornell Medicine/New York Presbyterian Hospital, New York, NY, USA.
Saeed A; Division of Medical Oncology, Department of Medicine, Kansas University Cancer Center, Westwood, KS, USA.
Huang YH; Division of Gastroenterology and Hepatology, Department of Medicine, Taipei.
Kudo M; Department of Gastroenterology and Hepatology, Kindai University Faculty of Medicine, Osaka-Sayama, Osaka, Japan.
Rimassa L; Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan, Italy.
Marron TU; Division of Hematology and Medical Oncology, Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
Pinato DJ; Imperial Centre for Translational and Experimental Medicine (ICTEM), 72 Du Cane Road, White City, London, W12 0NN, UK Division of Oncology, Department of Translational Medicine, Piemonte Orientale University, Novara, Italy.
Ang C; Division of Hematology and Medical Oncology, Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, 1 Gustave Levy Place, Box 1079, New York, NY 10029, USA.

Ther Adv Med Oncol ; 13: 17588359211010937, 2021.

Article em En | MEDLINE | ID: mdl-33995594

ABSTRACT

ABSTRACT

BACKGROUND:

Antibiotic exposure has been associated with worse outcomes with immune checkpoint inhibitors (ICIs) in cancer patients, likely due to disruption of the gut microbiome. Other commonly prescribed medications, such as proton pump inhibitors (PPIs) and histamine-2-receptor antagonists (H2RAs), are also known to disrupt the microbiome, but data on their association with ICI outcomes are conflicting.

METHODS:

We conducted a retrospective, multicenter, international cohort study including 314 hepatocellular carcinoma (HCC) patients treated with ICIs from 2017 to 2019 to assess the association between PPI or H2RA exposure (up to 30 days before ICI) and overall survival. Secondary outcomes included overall response rate (ORR) and development of any treatment-related adverse events (AEs).

RESULTS:

Baseline PPI/H2RA exposure was not associated with overall survival in univariable (HR 1.01, 95% CI 0.75-1.35) or multivariable analysis (HR 0.98, 95% CI 0.71-1.36). Baseline PPI/H2RA exposure was not associated with either ORR (OR 1.32, 95% CI 0.66-2.65) or AEs (OR 1.07, 95% CI 0.54-2.12) in multivariable analysis.