PPI 治疗对接受 PD-L1 抑制剂治疗的晚期 SCLC 患者的临床结局有负面影响。
PPIs therapy has a negative impact on the clinical outcomes of advanced SCLC patients treated with PD-L1 inhibitors.
机构信息
Shandong First Medical University, Shandong Academy of Medical Sciences, Jinan, Shandong, 250062, China.
Department of Radiation Oncology, Shandong Cancer Hospital and Institute, Shandong First Medical University, Academy of Medical Sciences, Jinan, Shandong, 250117, China.
出版信息
BMC Pulm Med. 2023 Nov 11;23(1):438. doi: 10.1186/s12890-023-02754-4.
BACKGROUND
Programmed death-ligand 1 (PD-L1) inhibitors has emerged as a first-line therapeutic strategy for advanced small cell lung cancer (SCLC), which can stimulate T-cell activation, thereby preventing tumor avoidance of immunologic surveillance, whereas, proton pump inhibitors (PPIs) can play an important role in regulating immune function. This study assessed whether the concomitantly use of PPIs affected outcomes of immunotherapy in advanced SCLC.
METHODS
Data from advanced SCLC patients who firstly treated with PD-L1 inhibitors between July 2018 and February 2021 was retrospectively analyzed. The impact of concomitant medications (especially PPIs) on objective response rate, progression-free survival (PFS) and overall survival (OS) were evaluated.
RESULTS
Of 208 patients, 101 received immunotherapy concomitant PPIs. The median PFS of patients receiving PPIs (6.6 months) were significantly shorter than those without PPIs (10.6 months), and so was OS. There was associated with a 74.9% increased risk of progression and 58.3% increased risk of death. Both first-line and post-first-line immunotherapy, patients treated PPIs had poorer PFS.
CONCLUSION
PPIs therapy has a negative impact on the clinical outcomes of advanced SCLC patients treated with PD-L1 inhibitors.
背景
程序性死亡配体 1（PD-L1）抑制剂已成为治疗晚期小细胞肺癌（SCLC）的一线治疗策略，可刺激 T 细胞激活，从而防止肿瘤逃避免疫监测，而质子泵抑制剂（PPIs）可在调节免疫功能方面发挥重要作用。本研究评估了同时使用 PPIs 是否会影响晚期 SCLC 的免疫治疗结果。
方法
回顾性分析了 2018 年 7 月至 2021 年 2 月期间首次接受 PD-L1 抑制剂治疗的晚期 SCLC 患者的数据。评估了同时使用的药物（尤其是 PPIs）对客观缓解率、无进展生存期（PFS）和总生存期（OS）的影响。
结果
在 208 例患者中，有 101 例接受了免疫治疗同时使用了 PPIs。接受 PPI 治疗的患者的中位 PFS（6.6 个月）明显短于未使用 PPI 治疗的患者（10.6 个月），OS 也是如此。进展风险增加 74.9%，死亡风险增加 58.3%。在一线和一线后免疫治疗中，接受 PPI 治疗的患者 PFS 更差。
结论
PPIs 治疗对接受 PD-L1 抑制剂治疗的晚期 SCLC 患者的临床结局有负面影响。
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