Preprint Review Version 2 This version is not peer-reviewed

Impact of Use of Gastric-Acid Suppressants and Oral Anticancer Agents on Survival Outcomes: A Systematic Review and Meta-Analysis

Version 1 : Received: 14 March 2020 / Approved: 15 March 2020 / Online: 15 March 2020 (16:04:11 CET)
Version 2 : Received: 29 March 2020 / Approved: 31 March 2020 / Online: 31 March 2020 (03:40:46 CEST)

A peer-reviewed article of this Preprint also exists.

Indini, A.; Petrelli, F.; Tomasello, G.; Rijavec, E.; Facciorusso, A.; Grossi, F.; Ghidini, M. Impact of Use of Gastric-Acid Suppressants and Oral Anti-Cancer Agents on Survival Outcomes: A Systematic Review and Meta-Analysis. Cancers 2020, 12, 998. Indini, A.; Petrelli, F.; Tomasello, G.; Rijavec, E.; Facciorusso, A.; Grossi, F.; Ghidini, M. Impact of Use of Gastric-Acid Suppressants and Oral Anti-Cancer Agents on Survival Outcomes: A Systematic Review and Meta-Analysis. Cancers 2020, 12, 998.

Journal reference: Cancers 2020, 12, 998
DOI: 10.3390/cancers12040998

Abstract

We performed a systematic review and meta-analysis to evaluate the role of gastric acid suppressant use on outcomes of tyrosine kinase inhibitors (TKIs) and oral chemotherapy. We identified all researches evaluating the effect of GAS use on patients receiving oral chemotherapy or TKIs for solid tumors. The pooled hazard ratios (HRs) and 95% confidence interval (95% CI) for overall survival (OS) and progression-free survival (PFS) were calculated with fixed-effects or random-effects model. The study population included n=16 retrospective studies and 372,418 patients. Series concerned gastrointestinal tract tumors (n=5 studies), renal cell carcinomas (RCC, n=3 studies), non-small cell lung cancers (NSCLC, n=5 studies), and soft tissue sarcomas or mixed histologies solid tumors in n=3 studies. The pooled HRs for OS and PFS were 1.31 (95% CI: 1.20–1.43; P<01) and 1.3 (95%CI 1.07-1.57; P<0.01) for GAS and no GAS users, respectively. Only studies of EGFR mutated NSCLC patients receiving TKIs and those with colorectal cancer receiving oral chemotherapy showed a significant correlation between GAS and poor survival. Our study supports the evidence of a possible negative impact of concomitant GAS therapy on survival outcomes of patients receiving oral anti-cancer drugs.

Subject Areas

gastric acid suppressant; chemotherapy; tyrosine kinase inhibitors; proton pump inhibitors

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