The Impact ofConcomitantProton Pump Inhibitors Therapy on Clinical Outcome of Cancer Patients Treated with Immune Checkpoint Inhibitors: A Meta-analysis
Xing Cao 1†, Yafei Wang2 †, Wei Huang1, Panyun Li1, Chongjie Guo1, Yuhui Li1*
1Department of Oncology, The Central Hospital of Wuhan, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
2Department of Respiratory and Critical Care Medicine, The Central Hospital of Wuhan, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
These authors share first authorship
* Correspondence:
Yuhui Li
huihui090718@126.com
Background:In patients with advanced cancer receiving immune checkpoint inhibitors (ICIs) therapy, there are conflict perspectives about the influence of concomitant use of proton pump inhibitors (PPIs). We are aimed at exploring the influence of concomitant PPIs exposure on clinical outcome among cancer patients receiving ICIs treatment.
Methods: We searched relevant literatures in PubMed, EMBASE, and the Cochrane Library without language restrictions. We extracted the data from selected studies and calculated the pooled hazard ratios (HRs) with 95% confidence intervals (CIs) through professional software for overall survival (OS) and progression free survival (PFS) among cancer patients undergoing ICIs therapy exposed to PPIs.
Results: Fourteen studies including 6716 advanced cancer patients receiving ICIs treatment were appropriate for analysis judging by pre-set inclusion and exclusion criteria. The result indicated that concomitant PPIs exposure was significantly related to shorter OS (HR 1.388; 95%CI:1.278-1.498, P<0.001) and PFS (HR 1.285;95%CI:1.193-1.384, P<0.001) among multiple cancer patients receiving ICIs therapy.
Conclusions: Our meta-analysis showed that concomitant PPIs exposure had adverse impact on clinical outcome among patients receiving ICIs therapy. Clinical oncologists must be cautious of PPIs delivery during ICIs treatment.
Keywords:meta-analysis, immune checkpoint inhibitors (ICIs),overall survival (OS), proton pump inhibitors (PPIs), progression free survival (PFS).