Integrated analysis of concomitant medications and oncological outcomes from PD-1/PD-L1 checkpoint inhibitors in clinical practice

作者：Alessio Cortellini, Marco Tucci, Vincenzo Adamo, Luigia Stefania Stucci, Alessandro Russo, Enrica T. Tanda, Francesco Spagnolo, Francesca Rastelli, Renato Bisonni, Daniele Santini, Marco Russano, Cecilia Anesi, Raffaele Giusti, Marco Filetti, Paolo Marchetti, Andrea Botticelli, Alain Gelibter, Mario Occhipinti, Riccardo Marconcini, Maria Giuseppa Vitale, Linda Nicolardi, Rita Chiari, Claudia Bareggi, Olga Nigro, Alessandro Tuzi, Michele De Tursi, Nicola Petragnani, Laura Pala, Sergio Bracarda, Serena Macrini, Alessandro Inno, Federica Zoratto, Enzo Veltri, Barbara Di Cocco, Domenico Mallardo, Maria Grazia Vitale, David J. Pinato, Giampiero Porzio, Corrado Ficorella, Paolo A. Ascierto · 发表于：Journal for ImmunoTherapy of Cancer · 年份：2020 · DOI：10.1136/jitc-2020-001361 · 被引用次数：275 · 研究领域：Cancer Immunotherapy and Biomarkers、Cancer, Stress, Anesthesia, and Immune Response、Cancer, Lipids, and Metabolism

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), asp...