使用质子泵抑制剂、他汀类药物或二甲双胍与Pembrolizumab合用对转移性尿路上皮癌患者的影响：来自ARON-2回顾性研究的数据。
Use of concomitant proton pump inhibitors, statins or metformin in patients treated with pembrolizumab for metastatic urothelial carcinoma: data from the ARON-2 retrospective study.
发表日期：2023 Sep 07
作者：
Ondřej Fiala, Sebastiano Buti, Hideki Takeshita, Yohei Okada, Francesco Massari, Georgia Anguera Palacios, Michele Dionese, Sarah Scagliarini, Thomas Büttner, Giuseppe Fornarini, Zin W Myint, Luca Galli, Vinicius Carrera Souza, Renate Pichler, Ugo De Giorgi, María Natalia Gandur Quiroga, Danielle Gilbert, Lazar Popovic, Enrique Grande, Giulia Mammone, Rossana Berardi, Simon J Crabb, Javier Molina-Cerrillo, Marcelo Freitas, Murilo Luz, Roberto Iacovelli, Fabio Calabrò, Deniz Tural, Francesco Atzori, Zsófia Küronya, Rita Chiari, Saul Campos, Orazio Caffo, André P Fay, Jakub Kucharz, Paolo Andrea Zucali, José Augusto Rinck, Annalisa Zeppellini, Diogo Assed Bastos, Gaetano Aurilio, Augusto Mota, Karine Trindade, Cinzia Ortega, Juan Pablo Sade, Mimma Rizzo, Nuno Vau, Patrizia Giannatempo, Allan Barillas, Fernando Sabino Marques Monteiro, Breno Dauster, Carlo Cattrini, Lucas Nogueira, Roni de Carvalho Fernandes, Emmanuel Seront, Luís Garcia Aceituno, Francesco Grillone, Hernan Javier Cutuli, Mauricio Fernandez, Maria Bassanelli, Giandomenico Roviello, Halima Abahssain, Giuseppe Procopio, Michele Milella, Jindrich Kopecky, Angelo Martignetti, Carlo Messina, Manuel Caitano, Eva Inman, Ravindran Kanesvaran, Daniel Herchenhorn, Daniele Santini, Ray Manneh, Renato Bisonni, Roubini Zakopoulou, Alessandra Mosca, Franco Morelli, Fernando Maluf, Andrey Soares, Fernando Nunes, Alvaro Pinto, Anca Zgura, Lorena Incorvaia, Jawaher Ansari, Ignacio Ortego Zabalza, Johannes Landmesser, Alessandro Rizzo, Veronica Mollica, Giulia Sorgentoni, Nicola Battelli, Camillo Porta, Joaquim Bellmunt, Matteo Santoni
来源：
Experimental Hematology & Oncology
摘要：
伴随用药可能会对癌症患者的结果产生影响。在ARON-2现实世界研究（NCT05290038）的这个子分析中，我们旨在评估贲脲膜癌（mUC）患者接受二线奥珠单抗治疗期间质子泵抑制剂（PPI）、他汀类药物或二甲双胍的伴随使用对结果的影响。我们通过来自22个国家的87家机构的医院病历收集了贲脲膜癌患者接受奥珠单抗作为二线治疗的数据。我们评估了总生存期（OS）、无进展生存期（PFS）和总体有效率。我们通过Cox回归模型进行了生存分析。本回顾性研究共有802名患者符合条件；中位随访时间为15.3个月。相较于非使用者，PPI使用者的PFS（4.5 vs. 7.2个月，p = 0.002）和OS（8.7 vs. 14.1个月，p < 0.001）较差。经过多元Cox分析，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没有关联。我们的研究结果表明，在现实世界背景下，伴随使用PPI对接受奥珠单抗治疗的mUC患者有显著的预后影响。这种相互作用的机制需要进一步阐明。© 2023. 作者，Springer-Verlag GmbH Deutschland的独家许可，Springer Nature的一部分。
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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.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.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.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.© 2023. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.