TY - JOUR
T1 - Integrated analysis of concomitant medications and oncological outcomes from PD-1/PD-L1 checkpoint inhibitors in clinical practice
AU - Cortellini, Alessio
AU - Tucci, Marco
AU - Adamo, Vincenzo
AU - Stucci, Luigia Stefania
AU - Russo, Alessandro
AU - Tanda, Enrica Teresa
AU - Spagnolo, Francesco
AU - Rastelli, Francesca
AU - Bisonni, Renato
AU - Santini, Daniele
AU - Russano, Marco
AU - Anesi, Cecilia
AU - Giusti, Raffaele
AU - Filetti, Marco
AU - Marchetti, Paolo
AU - Botticelli, Andrea
AU - Gelibter, Alain
AU - Occhipinti, Mario Alberto
AU - Marconcini, Riccardo
AU - Vitale, Maria Giuseppa
AU - Nicolardi, Linda
AU - Chiari, Rita
AU - Bareggi, Claudia
AU - Nigro, Olga
AU - Tuzi, Alessandro
AU - De Tursi, Michele
AU - Petragnani, Nicola
AU - Pala, Laura
AU - Bracarda, Sergio
AU - Macrini, Serena
AU - Inno, Alessandro
AU - Zoratto, Federica
AU - Veltri, Enzo
AU - Di Cocco, Barbara
AU - Mallardo, Domenico
AU - Vitale, Maria Grazia
AU - Pinato, David James
AU - Porzio, Giampiero
AU - Ficorella, Corrado
AU - Ascierto, Paolo Antonio
N1 - Publisher Copyright: © Author(s) (or their employer(s)) 2020. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. Copyright: This record is sourced from MEDLINE/PubMed, a database of the U.S. National Library of Medicine
PY - 2020/11/1
Y1 - 2020/11/1
N2 - BACKGROUND: Concomitant medications, such as steroids, proton pump inhibitors (PPI) and antibiotics, might affect clinical outcomes with immune checkpoint inhibitors. METHODS: We conducted a multicenter observational retrospective study aimed at evaluating the impact of concomitant medications on clinical outcomes, by weighing their associations with baseline clinical characteristics (including performance status, burden of disease and body mass index) and the underlying causes for their prescription. This analysis included consecutive stage IV patients with cancer, who underwent treatment with single agent antiprogrammed death-1/programmed death ligand-1 (PD-1/PD-L1) with standard doses and schedules at the medical oncology departments of 20 Italian institutions. Each medication taken at the immunotherapy initiation was screened and collected into key categories as follows: corticosteroids, antibiotics, gastric acid suppressants (including proton pump inhibitors - PPIs), statins and other lipid-lowering agents, aspirin, anticoagulants, non-steroidal anti-inflammatory drugs (NSAIDs), ACE inhibitors/Angiotensin II receptor blockers, calcium antagonists, β-blockers, metformin and other oral antidiabetics, opioids. RESULTS: From June 2014 to March 2020, 1012 patients were included in the analysis. Primary tumors were: non-small cell lung cancer (52.2%), melanoma (26%), renal cell carcinoma (18.3%) and others (3.6%). Baseline statins (HR 1.60 (95% CI 1.14 to 2.25), p=0.0064), aspirin (HR 1.47 (95% CI 1.04 to 2.08, p=0.0267) and β-blockers (HR 1.76 (95% CI 1.16 to 2.69), p=0.0080) were confirmed to be independently related to an increased objective response rate. Patients receiving cancer-related steroids (HR 1.72 (95% CI 1.43 to 2.07), p
AB - BACKGROUND: Concomitant medications, such as steroids, proton pump inhibitors (PPI) and antibiotics, might affect clinical outcomes with immune checkpoint inhibitors. METHODS: We conducted a multicenter observational retrospective study aimed at evaluating the impact of concomitant medications on clinical outcomes, by weighing their associations with baseline clinical characteristics (including performance status, burden of disease and body mass index) and the underlying causes for their prescription. This analysis included consecutive stage IV patients with cancer, who underwent treatment with single agent antiprogrammed death-1/programmed death ligand-1 (PD-1/PD-L1) with standard doses and schedules at the medical oncology departments of 20 Italian institutions. Each medication taken at the immunotherapy initiation was screened and collected into key categories as follows: corticosteroids, antibiotics, gastric acid suppressants (including proton pump inhibitors - PPIs), statins and other lipid-lowering agents, aspirin, anticoagulants, non-steroidal anti-inflammatory drugs (NSAIDs), ACE inhibitors/Angiotensin II receptor blockers, calcium antagonists, β-blockers, metformin and other oral antidiabetics, opioids. RESULTS: From June 2014 to March 2020, 1012 patients were included in the analysis. Primary tumors were: non-small cell lung cancer (52.2%), melanoma (26%), renal cell carcinoma (18.3%) and others (3.6%). Baseline statins (HR 1.60 (95% CI 1.14 to 2.25), p=0.0064), aspirin (HR 1.47 (95% CI 1.04 to 2.08, p=0.0267) and β-blockers (HR 1.76 (95% CI 1.16 to 2.69), p=0.0080) were confirmed to be independently related to an increased objective response rate. Patients receiving cancer-related steroids (HR 1.72 (95% CI 1.43 to 2.07), p
KW - immunotherapy
U2 - 10.1136/jitc-2020-001361
DO - 10.1136/jitc-2020-001361
M3 - Article
VL - 8
JO - J. Immunother. Cancer
JF - J. Immunother. Cancer
SN - 2051-1426
IS - 2
ER -