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Antacid exposure and immunotherapy outcomes among patients with advanced hepatocellular carcinoma

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 (H2RA...

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Autores principales: 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
Formato: Online Artículo Texto
Lenguaje:English
Publicado: SAGE Publications 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8107671/
https://www.ncbi.nlm.nih.gov/pubmed/33995594
http://dx.doi.org/10.1177/17588359211010937
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author 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
author_facet 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
author_sort Jun, Tomi
collection PubMed
description 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.
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spelling pubmed-81076712021-05-14 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 Ther Adv Med Oncol Original Research 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. SAGE Publications 2021-04-28 /pmc/articles/PMC8107671/ /pubmed/33995594 http://dx.doi.org/10.1177/17588359211010937 Text en © The Author(s), 2021 https://creativecommons.org/licenses/by/4.0/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).
spellingShingle Original Research
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
Antacid exposure and immunotherapy outcomes among patients with advanced hepatocellular carcinoma
title Antacid exposure and immunotherapy outcomes among patients with advanced hepatocellular carcinoma
title_full Antacid exposure and immunotherapy outcomes among patients with advanced hepatocellular carcinoma
title_fullStr Antacid exposure and immunotherapy outcomes among patients with advanced hepatocellular carcinoma
title_full_unstemmed Antacid exposure and immunotherapy outcomes among patients with advanced hepatocellular carcinoma
title_short Antacid exposure and immunotherapy outcomes among patients with advanced hepatocellular carcinoma
title_sort antacid exposure and immunotherapy outcomes among patients with advanced hepatocellular carcinoma
topic Original Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8107671/
https://www.ncbi.nlm.nih.gov/pubmed/33995594
http://dx.doi.org/10.1177/17588359211010937
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