Ha Vincent H, Ngo Margaret, Chu Michael P, Ghosh Sunita, Sawyer Michael B, Chambers Carole R
Pharmacy Department, Cross Cancer Institute, Canada Faculty of Pharmacy and Pharmaceutical Sciences, University of Alberta, Canada.
Faculty of Pharmacy and Pharmaceutical Sciences, University of Alberta, Canada Pharmacy Department, Tom Baker Cancer Centre, Canada.
J Oncol Pharm Pract. 2015 Jun;21(3):194-200. doi: 10.1177/1078155214527145. Epub 2014 Mar 24.
Renal cell cancer is a chemotherapy-insensitive cancer treated by vascular endothelial growth factor receptor antagonists. Recently, a question has arisen on whether there is an interaction between tyrosine kinase inhibitors, such as sunitinib, and acid suppressing agents.
A retrospective chart review was conducted for patients at two tertiary care centers who received sunitinib between 1 January 2006 and 31 March 2013. Using electronic systems and a province-wide electronic health records database, medication dispensing records were obtained. A univariate Cox's proportional hazard model determined if acid suppression had effects on progression-free survival and overall survival.
Of 383 patient charts reviewed, 231 were included in the study. Patients on intermittent acid suppression, lost to follow-up or received sunitinib for less than one week were excluded from the study. The median age of the study population was 65. Patients who received no acid suppression (n = 186) had a median progression-free survival of 23.6 weeks (95% CI, 19.0-31.9 weeks) and patients who received continuous acid suppression (n = 45) had a median progression-free survival of 18.9 weeks (95% CI, 11.0-23.7 p = 0.04). A median overall survival of 62.4 weeks (95% CI, 42.0-82.7 weeks) was observed in the group with no acid suppression, while a median overall survival of 40.9 weeks (95% CI, 26.1-74.4 weeks) was observed in the continuous acid suppression group (p = 0.02).
There was a significant difference in progression-free survival and overall survival between the acid suppressed and no acid suppression groups. Further research is required to confirm this potential interaction.
肾细胞癌是一种对化疗不敏感的癌症，可通过血管内皮生长因子受体拮抗剂进行治疗。最近，关于舒尼替尼等酪氨酸激酶抑制剂与抑酸剂之间是否存在相互作用的问题引发了关注。
对2006年1月1日至2013年3月31日期间在两家三级医疗中心接受舒尼替尼治疗的患者进行回顾性病历审查。利用电子系统和全省电子健康记录数据库获取用药配药记录。采用单变量Cox比例风险模型确定抑酸对无进展生存期和总生存期是否有影响。
在审查的383份患者病历中，231份纳入研究。间歇性抑酸、失访或接受舒尼替尼治疗少于一周的患者被排除在研究之外。研究人群的中位年龄为65岁。未接受抑酸治疗的患者（n = 186）的中位无进展生存期为23.6周（95%CI，19.0 - 31.9周），接受持续抑酸治疗的患者（n = 45）的中位无进展生存期为18.9周（95%CI，11.0 - 23.7，p = 0.04）。未接受抑酸治疗组的中位总生存期为62.4周（95%CI，42.0 - 82.7周），而持续抑酸治疗组的中位总生存期为40.9周（95%CI，26.1 - 74.4周）（p = 0.02）。
抑酸组和未抑酸组在无进展生存期和总生存期方面存在显著差异。需要进一步研究来证实这种潜在的相互作用。
