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01-01-2022 | Kidney Cancer | Original Research Article

Concomitant Proton Pump Inhibitors and Outcome of Patients Treated with Nivolumab Alone or Plus Ipilimumab for Advanced Renal Cell Carcinoma

Authors: Veronica Mollica, Matteo Santoni, Marc R. Matrana, Umberto Basso, Ugo De Giorgi, Alessandro Rizzo, Marco Maruzzo, Andrea Marchetti, Matteo Rosellini, Sara Bleve, Diana Maslov, Karine Tawagi, Ernest Philon, Zoe Blake, Francesco Massari

Published in: Targeted Oncology | Issue 1/2022

Abstract

Background

Immune checkpoint inhibitors (ICIs) represent the standard of care as first- or second-line treatment in patients with renal cell carcinoma (RCC). Proton pump inhibitors (PPIs) are among the most prescribed drugs worldwide and are known to affect gut microbiota, which is gaining interest in its association with outcomes for patients on ICIs.

Objective

The aim of this study was to evaluate the impact of PPIs on outcomes in RCC patients receiving immunotherapy.

Patients and Methods

We retrospectively collected data from patients with metastatic RCC who received the combination of ipilimumab and nivolumab for first-line treatment (Cohort 1) or single-agent nivolumab for second-line or third-line treatment (Cohort 2) from five international centers with expertise in the treatment of RCC. Data about clinicopathological characteristics, PPI use, and outcome on ICIs were collected. Endpoints of the study were objective response rate (ORR), progression-free survival (PFS), and overall survival (OS).

Results

Two hundred and eighteen patients (71% male, median age 61 years) were included in the analysis, 62 in Cohort 1 (including 25 patients receiving PPIs) and 156 in Cohort 2 (including 88 patients receiving PPIs), and were followed up for a median of 42 months. In Cohort 1, no difference was observed in ORR (48% vs 57%; p = 0.203), PFS (12.2 vs 8.5 months; p = 0.928), or OS (not reached [NR] vs 27.3 months; p = 0.84). In Cohort 2, no difference was observed in ORR (32% vs 28%; p = 0.538), PFS (6.7 vs 9.0 months; p = 0.799), or OS (16.0 vs 26.0 months; p = 0.324).

Conclusions

In patients with RCC, concomitant PPI use did not seem to affect survival outcomes on ICIs, either as combination therapy or monotherapy.

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Title: Concomitant Proton Pump Inhibitors and Outcome of Patients Treated with Nivolumab Alone or Plus Ipilimumab for Advanced Renal Cell Carcinoma
Authors: Veronica Mollica
Matteo Santoni
Marc R. Matrana
Umberto Basso
Ugo De Giorgi
Alessandro Rizzo
Marco Maruzzo
Andrea Marchetti
Matteo Rosellini
Sara Bleve
Diana Maslov
Karine Tawagi
Ernest Philon
Zoe Blake
Francesco Massari
Publication date: 01-01-2022
Publisher: Springer International Publishing
Keywords: Kidney Cancer
Kidney Cancer
Proton Pump Inhibitors
Kidney Cancer
Respiratory Microbiota
Checkpoint Inhibitors
Published in: Targeted Oncology / Issue 1/2022
Print ISSN: 1776-2596
Electronic ISSN: 1776-260X
DOI: https://doi.org/10.1007/s11523-021-00861-y

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