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Antacid exposure and immunotherapy outcomes among patients with advanced hepatocellular carcinoma

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Title: Antacid exposure and immunotherapy outcomes among patients with advanced hepatocellular carcinoma
Authors: Jun, T
Ozbek, U
Dharmapuri, S
Hardy-Abeloos, C
Zhu, H
Lin, J-Y
Personeni, N
Pressiani, T
Lee, P
Lee, C
Hildebrand, H
Nimkar, N
Paul, S
Fessas, P
Naeem, M
Bettinger, D
Khan, U
Saeed, A
Huang, Y
Kudo, M
Rimassa, L
Marron, T
Pinato, D
Ang, C
Item Type: Journal Article
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. Conclusions: Our results suggest that exposure to PPI/H2RA prior to ICIs does not adversely affect outcomes in HCC patients.
Issue Date: 28-Apr-2021
Date of Acceptance: 22-Mar-2021
URI: http://hdl.handle.net/10044/1/89078
DOI: 10.1177/17588359211010937
ISSN: 1758-8340
Publisher: SAGE Publications
Start Page: 1
End Page: 14
Journal / Book Title: Therapeutic Advances in Medical Oncology
Volume: 13
Copyright Statement: © The Author(s), 2021. Article reuse guidelines: sagepub.com/journalspermissions. Creative Commons CC BY: This article is distributed under the terms of the Creative Commons Attribution 4.0 License (https://creativecommons.org/licenses/by/4.0/) which permits any use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access pages (https://us.sagepub.com/en-us/nam/open-access-at-sage).
Sponsor/Funder: Wellcome Trust
Funder's Grant Number: 204834/Z/16/Z
Publication Status: Published
Online Publication Date: 2021-04-28
Appears in Collections:Department of Surgery and Cancer



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