Clinical impact of tetracyclines and/or proton pump inhibitors on the efficacy of epidermal growth factor receptor inhibitors in non-small cell lung cancer: a retrospective cohort study.
Humans
Antineoplastic Agents
/ therapeutic use
Carcinoma, Non-Small-Cell Lung
/ drug therapy
ErbB Receptors
/ antagonists & inhibitors
Erlotinib Hydrochloride
Gefitinib
/ therapeutic use
Lung Neoplasms
/ drug therapy
Mutation
Protein Kinase Inhibitors
/ therapeutic use
Proton Pump Inhibitors
/ therapeutic use
Quinazolines
Retrospective Studies
Tetracyclines
/ therapeutic use
Epidermal growth factor receptor-tyrosine kinase inhibitors
Non-small cell lung cancer
Proton pump inhibitor
Tetracyclines
Journal
BMC cancer
ISSN: 1471-2407
Titre abrégé: BMC Cancer
Pays: England
ID NLM: 100967800
Informations de publication
Date de publication:
13 Feb 2023
13 Feb 2023
Historique:
received:
02
04
2022
accepted:
08
02
2023
entrez:
14
2
2023
pubmed:
15
2
2023
medline:
16
2
2023
Statut:
epublish
Résumé
This retrospective cohort study examined the impact of tetracyclines (TCs) and proton pump inhibitors (PPIs) alone or in combination on the efficacy of epidermal growth factor receptor tyrosine kinase inhibitors (EGFR-TKIs) in patients with non-small cell lung cancer (NSCLC). Patients with NSCLC treated with gefitinib or erlotinib for at least 1 week between January 2009 and October 2021 were enrolled and divided into four groups based on the presence/absence of TC and/or PPI in the therapeutic regimen: TC-/PPI-, TC + /PPI-, TC-/PPI + , TC + /PPI + . Progression-free survival (PFS) and overall survival (OS) were the primary and secondary endpoints, respectively. The estimated median PFS and OS of 347 included patients with NSCLC were 8.57 (95% confidence interval [CI]: 7.66-9.48) months and 13.10 (95% CI: 11.03-15.17) months, respectively. Co-administration of EGFR-TKIs with PPIs decreased the PFS and OS, while that with TCs improved the PFS and OS. However, the concomitant use of EGFR-TKIs, TCs, and PPIs yielded survival rates similar to that of EGFR-TKI therapy alone. The administration of EGFR-TKIs with other drugs poses a challenge in managing patients with NSCLC. Therefore, reassessing the indications and necessity of TC or PPI therapy is essential for patients receiving erlotinib or gefitinib. The benefits and risks of possible discontinuation due to the clinical relevance of this interaction should be considered.
Sections du résumé
BACKGROUND
BACKGROUND
This retrospective cohort study examined the impact of tetracyclines (TCs) and proton pump inhibitors (PPIs) alone or in combination on the efficacy of epidermal growth factor receptor tyrosine kinase inhibitors (EGFR-TKIs) in patients with non-small cell lung cancer (NSCLC).
METHODS
METHODS
Patients with NSCLC treated with gefitinib or erlotinib for at least 1 week between January 2009 and October 2021 were enrolled and divided into four groups based on the presence/absence of TC and/or PPI in the therapeutic regimen: TC-/PPI-, TC + /PPI-, TC-/PPI + , TC + /PPI + . Progression-free survival (PFS) and overall survival (OS) were the primary and secondary endpoints, respectively.
RESULTS
RESULTS
The estimated median PFS and OS of 347 included patients with NSCLC were 8.57 (95% confidence interval [CI]: 7.66-9.48) months and 13.10 (95% CI: 11.03-15.17) months, respectively. Co-administration of EGFR-TKIs with PPIs decreased the PFS and OS, while that with TCs improved the PFS and OS. However, the concomitant use of EGFR-TKIs, TCs, and PPIs yielded survival rates similar to that of EGFR-TKI therapy alone.
CONCLUSIONS
CONCLUSIONS
The administration of EGFR-TKIs with other drugs poses a challenge in managing patients with NSCLC. Therefore, reassessing the indications and necessity of TC or PPI therapy is essential for patients receiving erlotinib or gefitinib. The benefits and risks of possible discontinuation due to the clinical relevance of this interaction should be considered.
Identifiants
pubmed: 36782147
doi: 10.1186/s12885-023-10623-w
pii: 10.1186/s12885-023-10623-w
pmc: PMC9926858
doi:
Substances chimiques
Antineoplastic Agents
0
ErbB Receptors
EC 2.7.10.1
Erlotinib Hydrochloride
DA87705X9K
Gefitinib
S65743JHBS
Protein Kinase Inhibitors
0
Proton Pump Inhibitors
0
Quinazolines
0
Tetracyclines
0
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
151Informations de copyright
© 2023. The Author(s).
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