PDF(Pubmed)
Abstract：
UNASSIGNED: There is limited research on whether Proton Pump Inhibitors (PPIs) will affect the efficacy of immune checkpoint inhibitors (ICIs) in treating hepatocellular carcinoma (HCC).This study aimed to determine whether PPIs affect the survival outcomes of patients with HBV-associated advanced HCC receiving combination therapy based on ICIs.
UNASSIGNED: We retrospectively analyzed patients with hepatitis B virus (HBV)-associated advanced HCC who underwent ICIs combination therapy from January 1, 2020, to December 30, 2022. Patients were stratified into PPI and non-PPI groups based on whether they received PPI treatment within 30 days before or after ICIs therapy. Patients\' survival and the risk of PPI-associated mortality was assessed. Adverse events were also evaluated.
UNASSIGNED: A total of 183 patients with HBV-associated HCC treated with ICI combination therapy were included. The median survival time (12.5 months vs 13.7 months, P = 0.285) and incidence of adverse events (P = 0.729) did not significantly differ between the PPI and non-PPI groups. Even after propensity score matching, the difference in median overall survival (OS) between the two groups was not significant (10.7 months vs 11.4 months; P = 0.596) and the patient\'s OS is not significantly related to the dosage of PPI application (P > 0.05).However, according to our subgroup analysis, among HCC patients with a serum HBV DNA concentration ≥ 200 IU/mL, the use of PPIs significantly increased the risk of mortality in patients receiving ICI combination therapy (P = 0.024).
UNASSIGNED: PPIs do not notably influence the survival prognosis of patients receiving ICI combination therapy for HBV-associated advanced HCC. However, among patients with high levels of HBV DNA, PPIs increase the risk of mortality. Therefore, antiviral therapy should be intensified in the patients with HBVDNA > 200 IU/mL. Additionally, PPIs do not impact the incidence of adverse reactions in these patients.
UNASSIGNED: We retrospectively analyzed patients with hepatitis B virus (HBV)-associated advanced HCC who underwent ICIs combination therapy from January 1, 2020, to December 30, 2022. Patients were stratified into PPI and non-PPI groups based on whether they received PPI treatment within 30 days before or after ICIs therapy. Patients\' survival and the risk of PPI-associated mortality was assessed. Adverse events were also evaluated.
UNASSIGNED: A total of 183 patients with HBV-associated HCC treated with ICI combination therapy were included. The median survival time (12.5 months vs 13.7 months, P = 0.285) and incidence of adverse events (P = 0.729) did not significantly differ between the PPI and non-PPI groups. Even after propensity score matching, the difference in median overall survival (OS) between the two groups was not significant (10.7 months vs 11.4 months; P = 0.596) and the patient\'s OS is not significantly related to the dosage of PPI application (P > 0.05).However, according to our subgroup analysis, among HCC patients with a serum HBV DNA concentration ≥ 200 IU/mL, the use of PPIs significantly increased the risk of mortality in patients receiving ICI combination therapy (P = 0.024).
UNASSIGNED: PPIs do not notably influence the survival prognosis of patients receiving ICI combination therapy for HBV-associated advanced HCC. However, among patients with high levels of HBV DNA, PPIs increase the risk of mortality. Therefore, antiviral therapy should be intensified in the patients with HBVDNA > 200 IU/mL. Additionally, PPIs do not impact the incidence of adverse reactions in these patients.
摘要：
■关于质子泵抑制剂（PPI）是否会影响免疫检查点抑制剂（ICIs）治疗肝细胞癌（HCC）的功效的研究有限。本研究旨在确定PPIs是否会影响HBV相关晚期HCC患者接受基于ICIs的联合治疗的生存结果。
■我们回顾性分析了从2020年1月1日至2022年12月30日接受ICIs联合治疗的乙型肝炎病毒（HBV）相关晚期HCC患者。根据患者是否在ICIs治疗前或后30天内接受PPI治疗，将患者分为PPI组和非PPI组。评估患者的生存率和PPI相关死亡风险。还评估了不良事件。
■共有183例HBV相关HCC患者接受ICI联合治疗。中位生存时间（12.5个月vs13.7个月，PPI组和非PPI组之间P=0.285）和不良事件发生率（P=0.729）无显著差异。即使在倾向得分匹配之后，两组患者的中位总生存期(OS)差异不显著(10.7个月vs11.4个月;P=0.596),患者的OS与PPI应用剂量无显著相关性(P>0.05)。然而,根据我们的亚组分析,在血清HBVDNA浓度≥200IU/mL的HCC患者中，PPI的使用显著增加了ICI联合治疗患者的死亡风险(P=0.024).
■PPI不会显着影响接受ICI联合治疗的HBV相关晚期HCC患者的生存预后。然而,在HBVDNA水平高的患者中，PPI增加死亡风险。因此,HBVDNA>200IU/mL的患者应加强抗病毒治疗。此外,PPI不会影响这些患者的不良反应发生率。
■我们回顾性分析了从2020年1月1日至2022年12月30日接受ICIs联合治疗的乙型肝炎病毒（HBV）相关晚期HCC患者。根据患者是否在ICIs治疗前或后30天内接受PPI治疗，将患者分为PPI组和非PPI组。评估患者的生存率和PPI相关死亡风险。还评估了不良事件。
■共有183例HBV相关HCC患者接受ICI联合治疗。中位生存时间（12.5个月vs13.7个月，PPI组和非PPI组之间P=0.285）和不良事件发生率（P=0.729）无显著差异。即使在倾向得分匹配之后，两组患者的中位总生存期(OS)差异不显著(10.7个月vs11.4个月;P=0.596),患者的OS与PPI应用剂量无显著相关性(P>0.05)。然而,根据我们的亚组分析,在血清HBVDNA浓度≥200IU/mL的HCC患者中，PPI的使用显著增加了ICI联合治疗患者的死亡风险(P=0.024).
■PPI不会显着影响接受ICI联合治疗的HBV相关晚期HCC患者的生存预后。然而,在HBVDNA水平高的患者中，PPI增加死亡风险。因此,HBVDNA>200IU/mL的患者应加强抗病毒治疗。此外,PPI不会影响这些患者的不良反应发生率。
