Influence of proton pump inhibitors on the pathological response of rectal cancer: a multicentre study.
5-fluorouracil
antacids
capecitabine
drug-drug interactions
rectal neoplasm
Journal
Ecancermedicalscience
ISSN: 1754-6605
Titre abrégé: Ecancermedicalscience
Pays: England
ID NLM: 101392236
Informations de publication
Date de publication:
2023
2023
Historique:
received:
09
01
2023
medline:
6
10
2023
pubmed:
6
10
2023
entrez:
6
10
2023
Statut:
epublish
Résumé
The standard neoadjuvant therapy for rectal cancer involves fluoropyrimidines and radiotherapy and, most recently, total neoadjuvant therapy (TNT). A drug-drug interaction between fluoropyrimidines and proton-pump inhibitors (PPI) was suggested, with a negative impact on oncological outcomes in breast, colon and gastric cancers. Little is known about such an effect on rectal tumours. We aimed to evaluate the impact of PPI utilisation on the pathological response after chemoradiation for rectal cancer. Retrospective multicentre study of rectal cancer patients treated with neoadjuvant chemoradiotherapy with capecitabine (cohort 1) or 5-fluororuracil (5-FU) (cohort 2); TNT with oxaliplatin-based regimens was allowed. The pathological response was considered a complete (ypCR) or complete + partial (ypCR + ypPR) according to American Joint Committee on Cancer. PPI use was considered at any time during the neoadjuvant period if concomitant to fluoropyrimidines. From January 2007 to November 2020, 251 patients received capecitabine and 196 5-FU. The rates of PPI use in cohorts 1 and 2 were 20.3% and 26.5%, respectively. TNT was offered to 18.3% in cohort 1. PPI use did not influence ypCR in cohort 1 (yes versus no: 29.4% versus 19.5%; PPI concomitant to capecitabine/5-FU chemoradiation did not influence the pathological response in rectal cancer but was associated with more treatment-related adverse events.
Sections du résumé
Background
UNASSIGNED
The standard neoadjuvant therapy for rectal cancer involves fluoropyrimidines and radiotherapy and, most recently, total neoadjuvant therapy (TNT). A drug-drug interaction between fluoropyrimidines and proton-pump inhibitors (PPI) was suggested, with a negative impact on oncological outcomes in breast, colon and gastric cancers. Little is known about such an effect on rectal tumours. We aimed to evaluate the impact of PPI utilisation on the pathological response after chemoradiation for rectal cancer.
Materials and methods
UNASSIGNED
Retrospective multicentre study of rectal cancer patients treated with neoadjuvant chemoradiotherapy with capecitabine (cohort 1) or 5-fluororuracil (5-FU) (cohort 2); TNT with oxaliplatin-based regimens was allowed. The pathological response was considered a complete (ypCR) or complete + partial (ypCR + ypPR) according to American Joint Committee on Cancer. PPI use was considered at any time during the neoadjuvant period if concomitant to fluoropyrimidines.
Results
UNASSIGNED
From January 2007 to November 2020, 251 patients received capecitabine and 196 5-FU. The rates of PPI use in cohorts 1 and 2 were 20.3% and 26.5%, respectively. TNT was offered to 18.3% in cohort 1. PPI use did not influence ypCR in cohort 1 (yes versus no: 29.4% versus 19.5%;
Conclusion
UNASSIGNED
PPI concomitant to capecitabine/5-FU chemoradiation did not influence the pathological response in rectal cancer but was associated with more treatment-related adverse events.
Identifiants
pubmed: 37799958
doi: 10.3332/ecancer.2023.1586
pii: can-17-1586
pmc: PMC10550299
doi:
Types de publication
Journal Article
Langues
eng
Pagination
1586Informations de copyright
© the authors; licensee ecancermedicalscience.
Déclaration de conflit d'intérêts
No conflicts of interest to declare.
Références
J Oncol Pharm Pract. 2019 Dec;25(8):1839-1845
pubmed: 30551722
Oncologist. 2021 Jun;26(6):e954-e962
pubmed: 33644953
Ann Surg. 2023 Oct 1;278(4):e766-e772
pubmed: 36661037
Clin Colorectal Cancer. 2016 Sep;15(3):257-63
pubmed: 26803708
JAMA Oncol. 2017 Jun 01;3(6):767-773
pubmed: 27737436
Br J Cancer. 2021 Sep;125(6):893-900
pubmed: 34253872
Am J Clin Oncol. 2021 Sep 1;44(9):487-494
pubmed: 34269694
Circ Res. 2016 Jun 10;118(12):e36-42
pubmed: 27166251
Curr Oncol. 2016 Dec;23(6):e583-e588
pubmed: 28050148
N Engl J Med. 2023 Jul 27;389(4):322-334
pubmed: 37272534
Nat Rev Cancer. 2006 Jul;6(7):546-58
pubmed: 16794637
J Natl Compr Canc Netw. 2021 May 5;19(9):1037-1044
pubmed: 33951613
Cancer Chemother Pharmacol. 2019 Jun;83(6):1127-1135
pubmed: 30972456
Zhonghua Zhong Liu Za Zhi. 2019 Sep 23;41(9):708-711
pubmed: 31550863
Clin Pharmacol Ther. 2022 Feb;111(2):455-460
pubmed: 34656072
JAMA Netw Open. 2021 Jun 1;4(6):e2113739
pubmed: 34132796
J Oncol Pharm Pract. 2019 Oct;25(7):1705-1711
pubmed: 31081468
J Gastrointest Cancer. 2023 Jun;54(2):545-553
pubmed: 35568776
Lancet Oncol. 2012 Jun;13(6):579-88
pubmed: 22503032
Nat Rev Gastroenterol Hepatol. 2017 Dec;14(12):697-710
pubmed: 28930292
Front Pharmacol. 2017 Dec 12;8:911
pubmed: 29311921
J Natl Cancer Inst. 2015 Sep 14;107(11):
pubmed: 26374429
Cancers (Basel). 2020 Oct 22;12(11):
pubmed: 33105819
Clin Colorectal Cancer. 2019 Mar;18(1):72-79
pubmed: 30551953
CA Cancer J Clin. 2021 May;71(3):209-249
pubmed: 33538338
Clin Transl Oncol. 2020 Aug;22(8):1288-1294
pubmed: 31853761
J Natl Cancer Inst. 2004 Nov 17;96(22):1702-13
pubmed: 15547183
Sci Rep. 2022 Apr 21;12(1):6561
pubmed: 35449143
Int J Cancer. 2018 Sep 15;143(6):1315-1326
pubmed: 29658114
Mol Pharm. 2013 Nov 4;10(11):4055-62
pubmed: 24044612
Int J Cancer. 2018 Dec 1;143(11):2758-2766
pubmed: 30095162
World J Gastroenterol. 2017 Apr 14;23(14):2575-2584
pubmed: 28465642
J Glob Oncol. 2019 Feb;5:1-19
pubmed: 30802158
Ann Oncol. 2009 Dec;20(12):1907-12
pubmed: 19713244
J Clin Pharmacol. 2016 Jul;56 Suppl 7:S157-72
pubmed: 27385173
Gastroenterology. 2015 Oct;149(4):883-5.e9
pubmed: 26164495
Oncotarget. 2017 Jun 16;8(35):58801-58808
pubmed: 28938598
Ann Oncol. 2017 Jul 1;28(suppl_4):iv22-iv40
pubmed: 28881920