Indini Alice, Petrelli Fausto, Tomasello Gianluca, Rijavec Erika, Facciorusso Antonio, Grossi Francesco, Ghidini Michele
Oncology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy.
Oncology Unit, ASST Bergamo Ovest, 24047 Treviglio (BG), Italy.
Cancers (Basel). 2020 Apr 18;12(4):998. doi: 10.3390/cancers12040998.
We performed a systematic review and meta-analysis to evaluate the role of gastric acid suppressant use on outcomes of tyrosine kinase inhibitors (TKIs) and oral chemotherapy. We identified all research evaluating the effect of GAS (gastric acid suppressants) use on patients receiving oral chemotherapy or TKIs for solid tumors. The pooled hazard ratios (HRs) and 95% confidence interval (95%CI) for overall survival (OS) and progression-free survival (PFS) were calculated with a fixed-effects or a random effects model. The study population included = 16 retrospective studies and 372,418 patients. The series concerned gastrointestinal tract tumors ( = 5 studies), renal cell carcinomas (RCC, = 3 studies), non-small cell lung cancers (NSCLC, = 5 studies), and soft tissue sarcomas or mixed histologies solid tumors in = 3 studies. The pooled HRs for OS and PFS were 1.31 (95%CI: 1.20-1.43; < 0.01) and 1.3 (95%CI 1.07-1.57; < 0.01) for GAS and no GAS users, respectively. Only studies of EGFR (epidermal growth factor receptor) mutated NSCLC patients receiving TKIs and those with colorectal cancer receiving oral chemotherapy showed a significant correlation between GAS and poor survival. Our study supports the evidence of a possible negative impact of concomitant GAS therapy on survival outcomes of patients receiving oral anti-cancer drugs.
我们进行了一项系统评价和荟萃分析，以评估使用胃酸抑制剂对酪氨酸激酶抑制剂（TKIs）和口服化疗疗效的影响。我们检索了所有评估使用胃酸抑制剂（GAS）对接受口服化疗或TKIs治疗实体瘤患者疗效的研究。采用固定效应或随机效应模型计算总生存期（OS）和无进展生存期（PFS）的合并风险比（HRs）及95%置信区间（95%CI）。研究人群包括16项回顾性研究和372418例患者。这些研究涉及胃肠道肿瘤（5项研究）、肾细胞癌（RCC，3项研究）、非小细胞肺癌（NSCLC，5项研究）以及软组织肉瘤或组织学类型混合的实体瘤（3项研究）。使用GAS和未使用GAS的患者，OS和PFS的合并HRs分别为1.31（95%CI：1.20 - 1.43；P < 0.01）和1.3（95%CI 1.07 - 1.57；P < 0.01）。仅接受TKIs治疗的表皮生长因子受体（EGFR）突变NSCLC患者以及接受口服化疗的结直肠癌患者的研究显示，使用GAS与生存不良之间存在显著相关性。我们的研究支持了同时使用GAS治疗可能对接受口服抗癌药物治疗患者的生存结局产生负面影响的证据。
