Will the commonly used stomach medicine reduce the treatment effect of lung cancer?

▎Proton Pump Inhibitor (PPI), edited by WuXi AppTec's content team, is a common drug used to treat diseases such as gastroesophageal reflux and ulcers
.

Professor Ashley M.
Hopkins of Flinders University pointed out: “Gastroesophageal reflux problems are very common in cancer patients.
About 30% of cancer patients are taking proton pump inhibitors for a long time
.

” Taking proton pump inhibition.
Does it affect the anti-cancer treatment of cancer patients? Recently, a study published in the British Journal of Cancer found that taking proton pump inhibitors may significantly reduce immunotherapy atezolizumab (atezolizumab) in the treatment of advanced non-small Efficacy of cell lung cancer
.

Screenshot source: British journal of cancer Atelizumab is an immune checkpoint inhibitor commonly used to treat lung cancer
.

The drug can enhance the function of the immune system, thereby being able to kill or control cancer cells
.

 In this study, the researchers included 1202 patients with non-small cell lung cancer, which were divided into 3 groups according to the treatment plan: BCP group (400 people): received bevacizumab + carboplatin + paclitaxel treatment; ACP group ( There were 402 people): received atelizumab + carboplatin + paclitaxel treatment; ABCP group (400 people): received atilizumab + bevacizumab + carboplatin + paclitaxel treatment
.

In these three groups, a total of 441 people used proton pump inhibitors at any time between 30 days before the start of treatment and 30 days after the start of treatment
.

The study found that in the ACP group and ABCP group, the use of proton pump inhibitors was associated with poor overall survival and poor progression-free survival: in the ACP group, compared to the same group without proton pump inhibitors In patients with proton pump inhibitors, the risk of death increased by 45% (RR=1.
45, P=0.
033), and the risk of disease progression or death increased by 38% (RR=1.
38, P=0.
014); in the ABCP group, use Participants with proton pump inhibitors increased the risk of death by 58% (RR=1.
58, P=0.
013), and the risk of disease progression or death increased by 21% (RR=1.
21, P=0.
173)
.

  However, this association was not obvious in the BCP group
.

The researchers also found that compared with the BCP group, the treatment regimen of the atelizumab group (ACP group and ABCP group), if the patients were treated with proton pump inhibitors, there was no significant difference in overall survival (RR=1.
03) ); but participants who did not receive proton pump inhibitor treatment had a 32% lower risk of death (RR=0.
68, P=0.
028)
.

There was a similar association in the ABCP group.
The overall survival of participants who used proton pump inhibitors was not significantly different from that of the BCP group (RR=0.
96); participants who did not use proton pump inhibitors had a 34% lower risk of death (RR= 0.
66, P=0.
095)
.

Picture source: The 123RF paper concludes: In patients receiving ACP or ABCP treatment, the use of proton pump inhibitors is a negative prognostic marker
.

The use of proton pump inhibitors and immunotherapy in the treatment of non-small cell lung cancer has significantly reduced the efficacy of atilizumab, but it will not affect the survival of patients who only receive chemotherapy drugs
.

The researchers explained the underlying reason: because proton pump inhibitors can cause significant changes in the intestinal flora, and the intestinal flora plays an important role in regulating immune function
.

Therefore, proton pump inhibitors may prevent the immune system from being activated, thereby affecting the effectiveness of immune checkpoint inhibitors for cancer treatment
.

The first author of the study, Professor Hopkins of Flinders University, pointed out: “It is worrying that proton pump inhibitors are often abused/improperly used because most people think that the drug will not cause other harm
.

Although we The results of the study need to be further verified, but it is time for oncologists to reconsider the use of proton pump inhibitors
.

” “At present, there is also more and more evidence that protons are observed in different cancer types.
The potential impact of pump inhibitors
.

However, the use of proton pump inhibitors is increasing worldwide, and it is urgent to determine the impact of proton pump inhibitors on cancer treatment
.

” Professor Hopkins added
.

Related reading "The Lancet-Oncology": What are the effects of the human microbiome on the occurrence and treatment of cancer? Commonly used drugs generally affect the gut microbiome! The efficacy and side effects may be related to the four-fold increase in the effect of cancer immunotherapy.
Is it actually related to this daily factor? "Nature": Are all the medicines for curing diseases eaten by the intestinal flora? You must not think of the consequences.
.
.
BMJ 200,000 people study: Don't eat common stomach medicines indiscriminately! Long-term use is prone to heart disease, kidney disease and gastric cancer.
References [1] Hopkins, AM, Kichenadasse, G.
, McKinnon, RA, Abuhelwa, AY, Logan, JM, Badaoui, S.
, .
.
.
& Sorich, MJ (2021 ).
Efficacy of first-line atezolizumab combination therapy in patients with non-small cell lung cancer receiving proton pump inhibitors: post hoc analysis of IMpower150.
British journal of cancer, 1-6.
[2] Common medication hindering lung cancer treatment.
Retrieved NOVEMBER 24, 2021, FROM https://medicalxpress.
com/news/2021-11-common-medication-hindering-lung-cancer.
html Disclaimer: WuXi AppTec's content team focuses on introducing global biomedical health research progress
.

This article is for the purpose of information exchange only.
The opinions expressed in the article do not represent the position of WuXi AppTec, nor does it mean that WuXi AppTec supports or opposes the views in the article
.

This article is not a treatment recommendation either
.

If you need treatment plan guidance, please go to a regular hospital for treatment
.