PDF(Pubmed)
Abstract：
BACKGROUND: Concomitant medications may potentially affect the outcome of cancer patients. In this sub-analysis of the ARON-2 real-world study (NCT05290038), we aimed to assess the impact of concomitant use of proton pump inhibitors (PPI), statins, or metformin on outcome of patients with metastatic urothelial cancer (mUC) receiving second-line pembrolizumab.
METHODS: We collected data from the hospital medical records of patients with mUC treated with pembrolizumab as second-line therapy at 87 institutions from 22 countries. Patients were assessed for overall survival (OS), progression-free survival (PFS), and overall response rate. We carried out a survival analysis by a Cox regression model.
RESULTS: A total of 802 patients were eligible for this retrospective study; the median follow-up time was 15.3 months. PPI users compared to non-users showed inferior PFS (4.5 vs. 7.2 months, p = 0.002) and OS (8.7 vs. 14.1 months, p < 0.001). Concomitant PPI use remained a significant predictor of PFS and OS after multivariate Cox analysis. The use of statins or metformin was not associated with response or survival.
CONCLUSIONS: Our study results suggest a significant prognostic impact of concomitant PPI use in mUC patients receiving pembrolizumab in the real-world context. The mechanism of this interaction warrants further elucidation.
METHODS: We collected data from the hospital medical records of patients with mUC treated with pembrolizumab as second-line therapy at 87 institutions from 22 countries. Patients were assessed for overall survival (OS), progression-free survival (PFS), and overall response rate. We carried out a survival analysis by a Cox regression model.
RESULTS: A total of 802 patients were eligible for this retrospective study; the median follow-up time was 15.3 months. PPI users compared to non-users showed inferior PFS (4.5 vs. 7.2 months, p = 0.002) and OS (8.7 vs. 14.1 months, p < 0.001). Concomitant PPI use remained a significant predictor of PFS and OS after multivariate Cox analysis. The use of statins or metformin was not associated with response or survival.
CONCLUSIONS: Our study results suggest a significant prognostic impact of concomitant PPI use in mUC patients receiving pembrolizumab in the real-world context. The mechanism of this interaction warrants further elucidation.
摘要：
背景：合并用药可能会影响癌症患者的预后。在ARON-2真实世界研究的这个子分析(NCT05290038)中，我们旨在评估伴随使用质子泵抑制剂（PPI）的影响，他汀类药物，或二甲双胍对接受二线pembrolizumab治疗的转移性尿路上皮癌（mUC）患者的预后。
方法：我们从来自22个国家的87个机构的接受pembrolizumab作为二线治疗的mUC患者的医院病历中收集数据。评估患者的总生存期（OS），无进展生存期（PFS），和总体反应率。我们通过Cox回归模型进行了生存分析。
结果：共有802例患者符合这项回顾性研究的条件；中位随访时间为15.3个月。PPI用户与非用户相比显示较差的PFS（4.5与7.2个月,p=0.002)和OS(8.7vs.14.1个月，p<0.001)。在多变量Cox分析后，伴随使用PPI仍然是PFS和OS的重要预测因子。他汀类药物或二甲双胍的使用与反应或生存无关。
结论：我们的研究结果表明，在真实世界背景下，在接受派姆单抗的mUC患者中，合并使用PPI对预后有显著影响。这种相互作用的机制值得进一步阐明。
方法：我们从来自22个国家的87个机构的接受pembrolizumab作为二线治疗的mUC患者的医院病历中收集数据。评估患者的总生存期（OS），无进展生存期（PFS），和总体反应率。我们通过Cox回归模型进行了生存分析。
结果：共有802例患者符合这项回顾性研究的条件；中位随访时间为15.3个月。PPI用户与非用户相比显示较差的PFS（4.5与7.2个月,p=0.002)和OS(8.7vs.14.1个月，p<0.001)。在多变量Cox分析后，伴随使用PPI仍然是PFS和OS的重要预测因子。他汀类药物或二甲双胍的使用与反应或生存无关。
结论：我们的研究结果表明，在真实世界背景下，在接受派姆单抗的mUC患者中，合并使用PPI对预后有显著影响。这种相互作用的机制值得进一步阐明。
