Abstract
Aim
We aimed to evaluate the effect of concomitant proton pump inhibitors (PPI) use with nivolumab on survival outcomes in metastatic renal cell carcinoma (mRCC) in second-line setting.
Methods
The study was designed as a multicenter and retrospective involving patients with metastatic renal cell carcinoma receiving second-line nivolumab therapy. One hundred and nine patients with mRCC were divided into two groups based on whether they use PPI concomitantly with nivolumab: concomitant PPI users and non-users. Overall survival (OS) and progression-free survival (PFS) were compared between the groups with and without concurrent PPIs.
Results
Of 109 patients in our study, 59 were not using PPI concomitantly with nivolumab and 50 were using PPI concomitantly. The median PFS was 6.37 (5.2–7.5) months in the concomitant PPI group and 9.7 (4.5–15) months in the non-users (p = 0.03). The median OS was 14.6 (7.1–22.1) months in patients on PPI concurrently with nivolumab and 29.9 (17.1–42.7) months in the non-users (p = 0.01). Accordingly, PPI use for PFS (Non-use vs. Use = HR: 0.44, 95%Cl 0.28–0.96, p = 0.014) and PPI use for OS (Non-use vs. Use = HR: 0.68, 95%Cl 0.22–0.88, p = 0.01) were found to be as independent risk factors.
Conclusions
Concomitant use of PPIs is associated with worse survival outcomes in patients with mRCC treated with nivolumab. Clinicians should carefully consider the concomitant use of PPIs in such patients.
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Data availability
Data will be provided by the corresponding author.
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Concept: MU, MZK and MA. Design: MU and MA. Supervision: all authors. Data collection and/or processing: all authors. Analysis and/or interpretation: MZK and MA. Literature search: MME, EH, TBG, MÇ, GD and DÇ. Writing: MU, SU, MZK, and MA. Critical reviews: all authors.
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Ethics approval was obtained from Necmettin Erbakan University Meram Medical Faculty, Konya, Turkey (Ethics Committee Number: 2022/4155).
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Uğraklı, M., Koçak, M.Z., Dinç, G. et al. The effect of concomitant proton pump inhibitor use on survival outcomes of Nivolumab-treated renal cell carcinoma patients: a multicenter study. J Cancer Res Clin Oncol 149, 9183–9189 (2023). https://doi.org/10.1007/s00432-023-04844-6
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DOI: https://doi.org/10.1007/s00432-023-04844-6