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Can Proton Pump Inhibitors Improve Outcomes With Pazopanib in Renal Cell Carcinoma?

By: Lauren Harrison, MS
Posted: Wednesday, October 27, 2021

Prolonged use of proton pump inhibitors (PPIs) in patients with metastatic renal cell carcinoma being treated with the kinase inhibitor pazopanib may be associated with a detrimental effect on progression-free survival. Marzia Del Re, PharmD, PhD, of the University Hospital of Pisa, Italy, presented these findings on behalf of her colleagues during the European Society for Medical Oncology (ESMO) Congress 2021  (Abstract 695P).

“It is recommended to prescribe PPIs with strict compliance with the registered indications and for short periods (usually not more than 2 weeks) or use alternative gastroprotective procedures,” concluded the authors.

This retrospective study enrolled 126 patients with metastatic renal cell carcinoma who were treated with pazopanib in the first-line setting. A total of 59 patients received no PPIs during pazopanib therapy, whereas 67 patients received PPIs for at least two-thirds of their pazopanib therapy. The most commonly used PPIs were lansoprazole and pantoprazole.

Among the entire population, the median progression free survival was 12 months. The investigators found no apparent difference in the overall population in terms of progression-free survival among the group taking PPIs compared with the group not taking PPIs. Patients were then stratified based on median progression-free survival into short (n = 70) and long (n = 56) responders. For the long responders, the progression-free survival was 24.7 months in patients taking PPIs, compared with 45.5 months among those not taking PPIs (P = .03).

Multivariate analyses were performed to account for gender, age, nephrectomy, radiotherapy, number of metastatic sites, European Cooperative Oncology Group status, and International Metastatic Renal Cell Carcinoma Database Consortium Risk scores. The use of concomitant PPIs was confirmed as the sole independent risk factor for shorter progression-free survival (P = .04).

Disclosure: The study authors reported no conflicts of interest.

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