Frontiers in Pharmacology (Sep 2022)

Effects of PPIs use on clinical outcomes of urothelial cancer patients receiving immune checkpoint inhibitor therapy

  • Lilong Zhang,
  • Chen Chen,
  • Dongqi Chai,
  • Chunlei Li,
  • Tianrui Kuang,
  • Li Liu,
  • Keshuai Dong,
  • Wenhong Deng,
  • Weixing Wang

DOI
https://doi.org/10.3389/fphar.2022.1018411
Journal volume & issue
Vol. 13

Abstract

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Objective: Immune checkpoint inhibitors (ICIs) have recently demonstrated promising performance in improving the prognosis of urological cancer patients. The goal of this meta-analysis was to determine the impact of PPI use on the clinical outcomes of urological cancer patients receiving ICI therapy.Methods: Before 6 May 2022, the eligible literature was searched using PubMed, EMBASE, Cochrane Library, and Google Scholar. The clinical outcomes were overall survival (OS), progression-free survival (PFS), and objective response rate (ORR).Results: A total of six articles met the inclusion criteria, and of the 1980 patients with advanced or metastatic urothelial cancers (UC) included. The meta-analysis displayed that PPI use could increase the risk of progression by 50.7% (HR: 1.507, 95% CI: 1.327–1.711, p < 0.001) and death by 58.7% (HR: 1.587, 95% CI: 1.367–1.842, p < 0.001), and reduce the ORR (OR: 0.503, 95% CI: 0.360–0.703, p < 0.001) in UC patients receiving ICIs. No significant heterogeneity and publication bias existed. Sensitivity analysis proved that the results were stable and reliable.Conclusion: The meta-analysis indicated that concomitant PPI use was significantly associated with low clinical benefit in UC patients.

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