质子抑制剂和癌症治疗:新出现的证据反对同时使用
Jean-Luc Raoul1, Philip D Hansten2
1Department of Clinical Research, Institut de Cancérologie de l'Ouest, Saint-Herblain, France.
Cancer treatment reviews
|July 5, 2024
概括
质子抑制剂 (PPI) 可以降低癌症药物的有效性,如铁激酶抑制剂 (TKI) 和免疫检查点抑制剂 (CPI). 医生应该考虑使用抗酸剂或H2阻断剂等替代药物来抑制癌症患者的酸性.
科学领域:
- 在瘤学瘤学.
- 药理学 药理学是指药理学的学科.
- 胃肠病学 胃肠病学
背景情况:
- 质子抑制剂 (PPI) 经常被处方给癌症患者.
- 累积的证据表明,PPI可能会干扰关键抗癌疗法的疗效,包括氨酸激酶抑制剂 (TKI) 和免疫检查点抑制剂 (CPI).
研究的目的:
- 审查PPI对主要抗癌药物有效性的影响.
- 突出 PPI 与特定癌症治疗同时使用的潜在风险.
主要方法:
- 对随机试验的回顾性研究和个人参与者数据的审查.
- 对癌症患者接受PPI与TKI,CPI和palbociclib一起接受PPI的结果的分析.
主要成果:
- 同时使用PPI与某些TKI (erlotinib,gefitinib,pazopanib) 的生存益处降低有关,原因是吸收受损,需要胃酸.
- 与那些不接受CPI和PPI治疗的患者相比,接受CPI和PPI治疗的患者表现较差 (总体存活率,无进展存活率,反应率).
- 在接受palbociclib.lib治疗的患者中观察到类似的负面影响.
结论:
- 关于在接受特定治疗的癌症患者中使用PPI,需要谨慎原则.
- 医生和患者应被告知PPI和抗癌药物之间的潜在相互作用.
- 对于需要减少酸的患者,替代性抑制酸的策略,如抗酸剂或H2阻断剂,可能是更好.
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