Clinical outcomes of concomitant use of proton pump inhibitors and regorafenib in patients with metastatic colorectal cancer: A multicenter study

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dc.authorid0000-0002-4972-9367en_US
dc.contributor.authorYekedüz, Emre
dc.contributor.authorÖzbay, Mehmet Fatih
dc.contributor.authorÇağlayan, Dilek
dc.contributor.authorYıldırım, Atila
dc.contributor.authorErol, Cihan
dc.contributor.authorYıldırım, Hasan Çağrı
dc.contributor.authorTunç, Sezai
dc.date.accessioned2023-03-28T12:56:35Z
dc.date.available2023-03-28T12:56:35Z
dc.date.issued2022en_US
dc.departmentDicle Üniversitesi, Tıp Fakültesi, Dahili Tıp Bilimleri Bölümü, Medikal Onkoloji Ana Bilim Dalıen_US
dc.description.abstractBackground: Tyrosine kinase inhibitors (TKI) are the most common oral drugs in cancer patients. Similarly, proton pump inhibitors (PPI) are commonly used to relieve dyspeptic symptoms in patients with cancer. However, gastric pH levels may affect the absorption of TKI through the gastrointestinal system. However, all TKIs do not have the same chemical structure, and the absorption rate of each TKI depends on their solubility in different gastric pH levels. Limited data is available about the clinical outcomes of concomitant use of PPI and regorafenib in patients with metastatic colorectal cancer (mCRC). We present here the results of the multicenter study following the initial results of our single-center experience. Methods: Patients with mCRC treated with regorafenib were included in this multicenter and retrospective study. Patients prescribed PPI after initiation of regorafenib were assigned to the PPI user group, and the remaining patients were assigned to the PPI non-user group. To exclude immortal time bias, the log-rank test was performed between PPI non-user and all patients. The primary outcome was overall survival (OS), and secondary outcomes were time to treatment failure (TTF) and adverse events (AEs) profile. Results: Two hundred and seventy-two patients from eight cancer centers were included in this study. Most patients were male (59.9%), had liver metastasis (62.1%), and received regorafenib in the third line (52.2%). The median age at the initiation of regorafenib was 60 years (interquartile range (IQR): 51-66)). Eastern Cooperative Oncology Group performance score was 0 or 1 in approximately three out of four patients. The rate of patients with K-RAS mutation was 46.7%. There were 131 (48.2%) and 141 (51.8%) in the PPI user and non-user groups, respectively. The most prescribed PPI was pantoprazole (40.4%). At a median 34.2 months follow-up, the median OS was 6.9 months (95% Confidence Interval (CI): 5.3-8.5) and 7.7 months (95% CI:6.6-8.8) in the PPI non-user and all patients, respectively. No statistical significance was observed between the groups (p = 0.913). The median TTF was 3.3 months (95% CI: 2.6-3.9) and 3.4 months (95% CI:2.9-4.0) in the PPI non-user and all patients, respectively. No statistical significance was observed between the groups (p = 0.651). In the time-dependent covariate Cox regression model, there was no difference between PPI user and non-user groups in OS and TTF (adjusted Hazard Ratio (aHR):0.96, 95% CI:0.74-1.24, p = 0.735 for OS; aHR:0.88, 0.68-1.14, p = 0.354 for TTF). The rates of all AEs were also similar in the PPI user and non-user groups (p = 0.628). Conclusions: To our knowledge, this was the first study evaluating the effect of concomitant use of PPI and regorafenib in patients with mCRC, and no adverse survival and safety outcome was observed with the concomitant use of PPI and regorafenib in those patients.en_US
dc.identifier.citationYekedüz, E., Mzbay, M.F., Çağlayan, D., Yıldırım, A., Erol, C., Yıldırım, H.Ç. ve diğerleri. (2022). Clinical outcomes of concomitant use of proton pump inhibitors and regorafenib in patients with metastatic colorectal cancer: A multicenter study. Journal of Clinical Oncology, 40(4(SI, meeting abstract: 130))en_US
dc.identifier.doi10.1200/JCO.2022.40.4_suppl.130
dc.identifier.issn0732-183X
dc.identifier.issn1527-7755
dc.identifier.issue4(SI, meeting abstract: 130)en_US
dc.identifier.pmid36266366
dc.identifier.scopus2-s2.0-85140336938
dc.identifier.scopusqualityQ1
dc.identifier.urihttps://ascopubs.org/doi/10.1200/JCO.2022.40.4_suppl.130
dc.identifier.urihttps://hdl.handle.net/11468/11544
dc.identifier.volume40en_US
dc.identifier.wosWOS:000770995900126
dc.identifier.wosqualityQ1
dc.indekslendigikaynakWeb of Science
dc.indekslendigikaynakScopus
dc.indekslendigikaynakPubMed
dc.institutionauthorTunç, Sezai
dc.language.isoenen_US
dc.publisherLippincott William & Wilkinsen_US
dc.relation.ispartofJournal of Clinical Oncology
dc.relation.publicationcategoryKonferans Öğesi - Uluslararası - Kurum Öğretim Elemanıen_US
dc.rightsinfo:eu-repo/semantics/openAccessen_US
dc.titleClinical outcomes of concomitant use of proton pump inhibitors and regorafenib in patients with metastatic colorectal cancer: A multicenter studyen_US
dc.titleClinical outcomes of concomitant use of proton pump inhibitors and regorafenib in patients with metastatic colorectal cancer: A multicenter study
dc.typeConference Objecten_US

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