Concomitant Administration of Proton Pump Inhibitors and Capecitabine is Associated With Increased Recurrence Risk in Early Stage Colorectal Cancer Patients

Sun, Julia; Ilich, Alastair; Kim, Christina; Chu, Michael P.; Wong, Gene K.; Ghosh, Sunita; Danilak, Melanie; Mulder, Karen; Spratlin, Jennifer L.; Chambers, Carole; Sawyer, Michael B.

doi:10.1016/j.clcc.2015.12.008

“…Similar findings were shown in a smaller trial (Lam et al, 2016). In 298 patients with operated colorectal cancer undergoing adjuvant therapy with Capecitabine those also taking PPIs had lower disease-free survival rates (Sun et al, 2016). Whilst certainly not conclusive, these data, together with the sound biochemical rationale of a possible interference of gastric acidity on drug bioavailability, pose an important question on the concomitant use of these drugs and suggest that whenever possible, PPIs should be discontinued during anticancer oral treatments.…”

Section: Interaction Of Ppi With Oral Anticancer Agentssupporting

confidence: 61%

Proton Pump Inhibitors in cancer patients: How useful they are? A review of the most common indications for their use

Numico

¹

,

Fusco

²

,

Franco

³

et al. 2017

Critical Reviews in Oncology/Hematology

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“…A total of 353 potentially eligible records were identified in the electronic databases. After exclusion of n=337 not pertinent papers, n=16 were selected for inclusion in quantitative analysis (n=372,418 patients included, with 12% of patients receiving concomitant GAS therapy) [16][17][18][19][20][21][22][23][24][25][26][27][28][29][30][31]. The search results and characteristics of the included studies are presented in figure 1 and tables 1-2.…”

Section: Resultsmentioning

confidence: 99%

Impact of Use of Gastric-Acid Suppressants and Oral Anticancer Agents on Survival Outcomes: A Systematic Review and Meta-Analysis

Indini¹,

Petrelli²,

Tomasello³

et al. 2020

Preprint

1

0

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We performed a systematic review and meta-analysis to evaluate the role of gastric acid suppressant use on outcomes of tyrosine kinase inhibitors (TKIs) and oral chemotherapy. We identified all researches evaluating the effect of GAS use on patients receiving oral chemotherapy or TKIs for solid tumors. The pooled hazard ratios (HRs) and 95% confidence interval (95% CI) for overall survival (OS) and progression-free survival (PFS) were calculated with fixed-effects or random-effects model. The study population included n=16 retrospective studies and 372,418 patients. Series concerned gastrointestinal tract tumors (n=5 studies), renal cell carcinomas (RCC, n=3 studies), non-small cell lung cancers (NSCLC, n=5 studies), and soft tissue sarcomas or mixed histologies solid tumors in n=3 studies. The pooled HRs for OS and PFS were 1.31 (95% CI: 1.20–1.43; P<01) and 1.3 (95%CI 1.07-1.57; P<0.01) for GAS and no GAS users, respectively. Only studies of EGFR mutated NSCLC patients receiving TKIs and those with colorectal cancer receiving oral chemotherapy showed a significant correlation between GAS and poor survival. Our study supports the evidence of a possible negative impact of concomitant GAS therapy on survival outcomes of patients receiving oral anti-cancer drugs.

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“…A total of 353 potentially eligible records were identified in the electronic databases. After exclusion of n=337 not pertinent papers, n=16 were selected for inclusion in quantitative analysis (n=372,418 patients included, with 12% of patients receiving concomitant GAS therapy) [16][17][18][19][20][21][22][23][24][25][26][27][28][29][30][31] All studies were retrospective except for a pooled analysis of phase 2-3 studies by Lalani et al and a secondary analysis of a randomized prospective trial by Chu et al Oncologic treatment consisted in oral TKIs in n=11 studies, while in n=4 studies patients received oral chemotherapy (i.e. capecitabine); one study did not include information regarding the type of study drugs.…”

Section: Resultsmentioning

confidence: 99%

Impact of Use of Gastric-Acid Suppressants and Oral Anticancer Agents on Survival Outcomes: A Systematic Review and Meta-Analysis

Indini¹,

Petrelli²,

Tomasello³

et al. 2020

Preprint

3

0

View full text Add to dashboard Cite

We performed a systematic review and meta-analysis to evaluate the role of gastric acid suppressant use on outcomes of tyrosine kinase inhibitors (TKIs) and oral chemotherapy. We identified all researches evaluating the effect of GAS use on patients receiving oral chemotherapy or TKIs for solid tumors. The pooled hazard ratios (HRs) and 95% confidence interval (95% CI) for overall survival (OS) and progression-free survival (PFS) were calculated with fixed-effects or random-effects model. The study population included n=16 retrospective studies and 372,418 patients. Series concerned gastrointestinal tract tumors (n=5 studies), renal cell carcinomas (RCC, n=3 studies), non-small cell lung cancers (NSCLC, n=5 studies), and soft tissue sarcomas or mixed histologies solid tumors in n=3 studies. The pooled HRs for OS and PFS were 1.31 (95% CI: 1.20–1.43; P<01) and 1.3 (95%CI 1.07-1.57; P<0.01) for GAS and no GAS users, respectively. Only studies of EGFR mutated NSCLC patients receiving TKIs and those with colorectal cancer receiving oral chemotherapy showed a significant correlation between GAS and poor survival. Our study supports the evidence of a possible negative impact of concomitant GAS therapy on survival outcomes of patients receiving oral anti-cancer drugs.

show abstract

Concomitant Administration of Proton Pump Inhibitors and Capecitabine is Associated With Increased Recurrence Risk in Early Stage Colorectal Cancer Patients

Cited by 56 publications

References 21 publications

Proton Pump Inhibitors in cancer patients: How useful they are? A review of the most common indications for their use

Proton Pump Inhibitors in cancer patients: How useful they are? A review of the most common indications for their use

Impact of Use of Gastric-Acid Suppressants and Oral Anticancer Agents on Survival Outcomes: A Systematic Review and Meta-Analysis

Impact of Use of Gastric-Acid Suppressants and Oral Anticancer Agents on Survival Outcomes: A Systematic Review and Meta-Analysis

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