2023 World Conference on Lung Cancer (Posters)-EP11.03. Proton Pump Inhibitors’ Impact on the Effectiveness of Immune Checkpoint Inhibitors in Metastatic Non-Small Cell Lung Cancer

EP11.03. Proton Pump Inhibitors’ Impact on the Effectiveness of Immune Checkpoint Inhibitors in Metastatic Non-Small Cell Lung Cancer - PDF(Slides)

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A study was conducted to investigate the impact of proton pump inhibitors (PPIs) on the effectiveness of immune checkpoint inhibitors (ICIs) in patients with metastatic non-small cell lung cancer (mNSCLC). ICIs have shown variable response rates in mNSCLC patients, and there is evidence suggesting that a favorable gut microbiome enhances the antitumor response. PPIs have been shown to cause unfavorable changes to the gut microbiome and may lead to poorer survival outcomes in NSCLC patients treated with ICIs.<br /><br />The study included retrospective data from mNSCLC patients who received an ICI at a multi-site community academic cancer center. The primary analysis focused on patients who received one ICI in the first-line setting, while the secondary analysis included all patients who received one ICI in any line of therapy. The primary endpoint was progression-free survival (PFS), and the secondary endpoints were overall survival (OS), best overall response (OR), and overall response rate (ORR).<br /><br />The results showed that there was no statistically significant difference in PFS or OS between patients exposed to PPIs and those who were not, in both the primary and secondary analyses. However, a trend towards improved PFS was observed in patients exposed to PPIs in both analyses. The OR and ORR were also similar between the two groups.<br /><br />Subgroup analyses showed that PPI use was associated with poorer survival outcomes in minorities compared to non-Hispanic Whites. Additionally, exploratory analyses stratified by race and sex showed that PPI use was associated with significantly prolonged OS in non-Hispanic White males, but not in non-Hispanic White females.<br /><br />Overall, based on the findings of this study, there is insufficient evidence to suggest that PPIs adversely impact survival and response outcomes to ICI therapy in patients with mNSCLC, regardless of the line of therapy. However, it is important to consider the limitations of the study, including its retrospective design, limited sample size, and reliance on patient-reported drug use and incomplete documentation.

Asset Subtitle

Luis Raez

Meta Tag

Speaker Luis Raez

Topic Metastatic NSCLC: Immunotherapy - Retrospective

Keywords

proton pump inhibitors

immune checkpoint inhibitors

metastatic non-small cell lung cancer

gut microbiome

progression-free survival

overall survival

best overall response

overall response rate

retrospective data

therapy limitations