{"title":"对服用抗酸剂的晚期非小细胞肺癌患者使用免疫检查点抑制剂的分析","authors":"Taisuke Isono, Hajime Furuno, Yoko Onodera, Tomoya Maruyama, Yuki Takeuchi, Ayaka Kojima, Takashi Nishida, Yoichi Kobayashi, Takashi Ishiguro, Yotaro Takaku, Kazuyoshi Kurashima, Naho Kagiyama","doi":"10.1016/j.resinv.2024.08.013","DOIUrl":null,"url":null,"abstract":"<div><h3>Background</h3><p>Proton pump inhibitors (PPIs) are reported to decrease the efficacy of immune checkpoint inhibitors (ICIs), but there are few reports on the association between ICI efficacy and antacids other than PPIs, and simultaneous examination of the effects of antacids, corticosteroids, and non-steroidal anti-inflammatory drugs (NSAIDs) on ICI therapy.</p></div><div><h3>Methods</h3><p>We conducted a retrospective study of 381 patients with non-small cell lung cancer who received ICI therapy from January 1, 2016 to December 31, 2022. The primary endpoint was overall survival (OS) and the secondary endpoint was progression-free survival (PFS). Antacids included histamine type 2 receptor antagonists (H2RAs), PPIs, and potassium-competitive acid blockers (P-CABs).</p></div><div><h3>Results</h3><p>Antacids were administered to 218 patients, including 168 with PPIs, 37 with P-CABs, and 13 with H2RAs. Patients with antacids had worse median PFS and OS than those without antacids (PFS, 2.9 vs. 6.2 months; OS, 12.3 vs. 24.0 months), and those with PPIs, P-CABs, or H2RAs had similar results. However, there were no significant differences between patients with and without antacids when stratified by corticosteroid and NSAID use. Multivariate analyses showed that corticosteroids and NSAIDs administered for cancer-associated symptoms were related to poor prognosis, but antacids including PPIs, P-CABs, or H2RAs were not related.</p></div><div><h3>Conclusions</h3><p>Antacids were not related to ICI efficacy when NSAIDs or corticosteroids were taken into consideration. This may be because the most frequent reason for administering NSAIDs and corticosteroids was cancer-associated symptoms, which are a poor prognostic factor, and most of the patients treated with these medications also received antacids.</p></div>","PeriodicalId":20934,"journal":{"name":"Respiratory investigation","volume":"62 6","pages":"Pages 951-959"},"PeriodicalIF":2.4000,"publicationDate":"2024-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Analysis of immune checkpoint inhibitors for advanced non-small cell lung cancer in patients receiving antacids\",\"authors\":\"Taisuke Isono, Hajime Furuno, Yoko Onodera, Tomoya Maruyama, Yuki Takeuchi, Ayaka Kojima, Takashi Nishida, Yoichi Kobayashi, Takashi Ishiguro, Yotaro Takaku, Kazuyoshi Kurashima, Naho Kagiyama\",\"doi\":\"10.1016/j.resinv.2024.08.013\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Background</h3><p>Proton pump inhibitors (PPIs) are reported to decrease the efficacy of immune checkpoint inhibitors (ICIs), but there are few reports on the association between ICI efficacy and antacids other than PPIs, and simultaneous examination of the effects of antacids, corticosteroids, and non-steroidal anti-inflammatory drugs (NSAIDs) on ICI therapy.</p></div><div><h3>Methods</h3><p>We conducted a retrospective study of 381 patients with non-small cell lung cancer who received ICI therapy from January 1, 2016 to December 31, 2022. The primary endpoint was overall survival (OS) and the secondary endpoint was progression-free survival (PFS). Antacids included histamine type 2 receptor antagonists (H2RAs), PPIs, and potassium-competitive acid blockers (P-CABs).</p></div><div><h3>Results</h3><p>Antacids were administered to 218 patients, including 168 with PPIs, 37 with P-CABs, and 13 with H2RAs. Patients with antacids had worse median PFS and OS than those without antacids (PFS, 2.9 vs. 6.2 months; OS, 12.3 vs. 24.0 months), and those with PPIs, P-CABs, or H2RAs had similar results. However, there were no significant differences between patients with and without antacids when stratified by corticosteroid and NSAID use. Multivariate analyses showed that corticosteroids and NSAIDs administered for cancer-associated symptoms were related to poor prognosis, but antacids including PPIs, P-CABs, or H2RAs were not related.</p></div><div><h3>Conclusions</h3><p>Antacids were not related to ICI efficacy when NSAIDs or corticosteroids were taken into consideration. This may be because the most frequent reason for administering NSAIDs and corticosteroids was cancer-associated symptoms, which are a poor prognostic factor, and most of the patients treated with these medications also received antacids.</p></div>\",\"PeriodicalId\":20934,\"journal\":{\"name\":\"Respiratory investigation\",\"volume\":\"62 6\",\"pages\":\"Pages 951-959\"},\"PeriodicalIF\":2.4000,\"publicationDate\":\"2024-08-25\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Respiratory investigation\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S2212534524001345\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"RESPIRATORY SYSTEM\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Respiratory investigation","FirstCategoryId":"1085","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S2212534524001345","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"RESPIRATORY SYSTEM","Score":null,"Total":0}
引用次数: 0
摘要
背景据报道,质子泵抑制剂(PPIs)会降低免疫检查点抑制剂(ICIs)的疗效,但关于ICI疗效与PPIs以外的抗酸剂之间的关联,以及同时检查抗酸剂、皮质类固醇和非甾体抗炎药(NSAIDs)对ICI治疗的影响的报道却很少。主要终点是总生存期(OS),次要终点是无进展生存期(PFS)。抗酸药包括组胺2型受体拮抗剂(H2RAs)、PPIs和钾竞争性酸阻滞剂(P-CABs)。结果 218例患者服用了抗酸药,其中168例服用了PPIs,37例服用了P-CABs,13例服用了H2RAs。与未服用抗酸药的患者相比,服用抗酸药患者的中位 PFS 和 OS 更差(PFS,2.9 个月 vs. 6.2 个月;OS,12.3 个月 vs. 24.0 个月),而服用 PPI、P-CAB 或 H2RA 的患者结果相似。然而,根据皮质类固醇和非甾体抗炎药的使用情况进行分层后,使用和未使用抗酸药的患者之间没有明显差异。多变量分析表明,因癌症相关症状而使用皮质类固醇和非甾体抗炎药与预后不良有关,但抗酸药(包括 PPI、P-CAB 或 H2RA)与预后不良无关。这可能是因为使用非甾体抗炎药和皮质类固醇的最常见原因是癌症相关症状,而这是一个不良预后因素,而且大多数使用这些药物治疗的患者也服用了抗酸剂。
Analysis of immune checkpoint inhibitors for advanced non-small cell lung cancer in patients receiving antacids
Background
Proton pump inhibitors (PPIs) are reported to decrease the efficacy of immune checkpoint inhibitors (ICIs), but there are few reports on the association between ICI efficacy and antacids other than PPIs, and simultaneous examination of the effects of antacids, corticosteroids, and non-steroidal anti-inflammatory drugs (NSAIDs) on ICI therapy.
Methods
We conducted a retrospective study of 381 patients with non-small cell lung cancer who received ICI therapy from January 1, 2016 to December 31, 2022. The primary endpoint was overall survival (OS) and the secondary endpoint was progression-free survival (PFS). Antacids included histamine type 2 receptor antagonists (H2RAs), PPIs, and potassium-competitive acid blockers (P-CABs).
Results
Antacids were administered to 218 patients, including 168 with PPIs, 37 with P-CABs, and 13 with H2RAs. Patients with antacids had worse median PFS and OS than those without antacids (PFS, 2.9 vs. 6.2 months; OS, 12.3 vs. 24.0 months), and those with PPIs, P-CABs, or H2RAs had similar results. However, there were no significant differences between patients with and without antacids when stratified by corticosteroid and NSAID use. Multivariate analyses showed that corticosteroids and NSAIDs administered for cancer-associated symptoms were related to poor prognosis, but antacids including PPIs, P-CABs, or H2RAs were not related.
Conclusions
Antacids were not related to ICI efficacy when NSAIDs or corticosteroids were taken into consideration. This may be because the most frequent reason for administering NSAIDs and corticosteroids was cancer-associated symptoms, which are a poor prognostic factor, and most of the patients treated with these medications also received antacids.