The Impact of Concomitant Proton Pump Inhibitors Therapy on Clinical
Outcome of Cancer Patients Treated with Immune Checkpoint Inhibitors: A
Meta-analysis
Abstract
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.