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一线联合治疗的晚期肾细胞癌患者中他汀类药物、二甲双胍或质子泵抑制剂的联合使用情况

Concomitant Use of Statins, Metformin, or Proton Pump Inhibitors in Patients with Advanced Renal Cell Carcinoma Treated with First-Line Combination Therapies.

作者信息

Santoni Matteo, Molina-Cerrillo Javier, Myint Zin W, Massari Francesco, Buchler Tomas, Buti Sebastiano, Matrana Marc R, De Giorgi Ugo, Rizzo Mimma, Zabalza Ignacio Ortego, Galli Luca, Zucali Paolo Andrea, Aurilio Gaetano, Incorvaia Lorena, Bassanelli Maria, Mammone Giulia, Salfi Alessia, Isella Luca, Mollica Veronica, Grande Enrique, Porta Camillo, Battelli Nicola

机构信息

Oncology Unit, Macerata Hospital, Macerata, Italy.

Department of Medical Oncology, Hospital Ramón y Cajal, Madrid, Spain.

出版信息

Target Oncol. 2022 Sep;17(5):571-581. doi: 10.1007/s11523-022-00907-9. Epub 2022 Aug 10.

Abstract

BACKGROUND

Drug-drug interactions are a major concern in oncology and may potentially affect the outcome of patients with cancer.

OBJECTIVE

In this study, we aimed to determine whether the concomitant use of statins, metformin, or proton pump inhibitors affects survival in patients with metastatic renal cell carcinoma treated with first-line combination therapies.

METHODS

Medical records of patients with documented metastatic renal cell carcinoma between January 2016 and November 2021 were reviewed at 17 participating centers. This research was conducted in ten institutions, including both referral centers and local hospitals. Patients were assessed for overall survival, progression-free survival, and overall clinical benefit. Univariate and multivariate analyses were conducted to explore the association of variables of interest with overall survival and progression-free survival.

RESULTS

A total of 304 patients receiving dual immunotherapy (51%) or immunotherapy/vascular endothelial growth factor-tyrosine kinase inhibitor (49%) combinations were eligible for inclusion in this retrospective study. Statin use was a significant prognostic factor for longer overall survival in a univariate analysis (hazard ratio 0.48, 95% confidence interval 0.26-0.87; p = 0.016) and a multivariate analysis (hazard ratio 0.48, 95% confidence interval 0.31-0.74; p < 0.001) and was significantly associated with an overall clinical benefit (83% in statin users vs 71% in non-users; p = 0.045). Otherwise, the use of metformin or proton pump inhibitors did not affect the outcome of these patients.

CONCLUSIONS

Our study suggests a prognostic impact of statin use in patients receiving first-line immuno-oncology combinations. The mechanism of this interaction warrants further elucidation.

摘要

背景

药物相互作用是肿瘤学中的一个主要问题,可能会影响癌症患者的治疗结果。

目的

在本研究中,我们旨在确定他汀类药物、二甲双胍或质子泵抑制剂的联合使用是否会影响接受一线联合治疗的转移性肾细胞癌患者的生存率。

方法

在17个参与中心回顾了2016年1月至2021年11月间有记录的转移性肾细胞癌患者的病历。本研究在包括转诊中心和当地医院在内的10个机构进行。对患者的总生存期、无进展生存期和总体临床获益进行评估。进行单因素和多因素分析以探讨感兴趣的变量与总生存期和无进展生存期之间的关联。

结果

共有304例接受双重免疫治疗(51%)或免疫治疗/血管内皮生长因子-酪氨酸激酶抑制剂联合治疗(49%)的患者符合纳入本回顾性研究的条件。在单因素分析(风险比0.48,95%置信区间0.26 - 0.87;p = 0.016)和多因素分析(风险比0.48,95%置信区间0.31 - 0.74;p < 0.001)中,他汀类药物的使用是总生存期延长的显著预后因素,并且与总体临床获益显著相关(他汀类药物使用者为83%,非使用者为71%;p = 0.045)。否则,二甲双胍或质子泵抑制剂的使用并未影响这些患者的治疗结果。

结论

我们的研究表明他汀类药物的使用对接受一线免疫肿瘤联合治疗的患者具有预后影响。这种相互作用的机制有待进一步阐明。

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