Impact of proton-pump inhibitors on the efficacy of immune checkpoint inhibitors in non-small cell lung cancer: A systematic review and meta-analysis

• Published in: Annals of medicine and surgery 2022-06, Vol.78, p.103752-103752, Article 103752
• Main Authors: Dar, Sophia, Merza, Nooraldin, Rahim, Mehek, Qatani, Ahmad, Varughese, Tony, Mohammad, Asna, Masood, Fahad, Reza, Fizza, Shucenwan, Almas, Talal, Ellahi, Aayat, Ligresti, Rosario
• Format: Article
• Language: English
• Subjects: Cancer; Immune checkpoint inhibitors; Non- small cell lung cancer; Proton pump inhibitor; Survival outcomes; Systematic Review / Meta-analysis
• ISSN: 2049-0801; 2049-0801
• DOI: 10.1016/j.amsu.2022.103752

Immune checkpoint inhibitors (ICI) is a rapidly evolving treatment modality for stage IV non-small cell lung cancer (NSCLC). Concomitant proton pump inhibitor (PPI) use can potentially reduce the clinical efficacy of ICIs; however, the consensus in recent literature has been conflicting. This study aims to analyze overall survival (OS) and progression-free survival (PFS) outcomes in patients with NSCLC on ICI and concomitant PPI therapy. A literature search was done in 3 databases (Pubmed/Medline, Embase, and Cochrane Central). All studies meeting the inclusion criteria assessing the impact of PPIs on the efficacy of ICI in NSCLC patients were systematically identified. A random-effects network meta-analysis evaluated OS and PFS in the two arms. Four studies with 2,940 patients are included in our analysis. ICI usage alone was associated with significantly better OS [HR = 1.46, 95% CI = 1.27–1.67, P