Authors (including presenting author) :
Chu MH(1)(2), Chong CH(1), Zhou KR(2)
Affiliation :
(1)Department of Pharmacy, The United Christian Hospital, Hong Kong (2)School of Pharmacy, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong
Introduction :
Tyrosine kinase inhibitors (TKIs) exhibit remarkable efficacy over chemotherapy in non-small cell lung cancer (NSCLC) patients with mutations in epidermal growth factor receptor (EGFR). However, concurrent therapy of gastric acid suppressants (AS) may reduce absorption of TKIs and hence affect the clinical outcome.
Objectives :
This study aims to investigate the effect of AS on progression-free survival, overall survival and adverse effects.
Methodology :
This study is a retrospective study. Adult patients taking erlotinib or gefitinib for non-small cell lung cancer with EGFR positive mutations were recruited. Patients concurrently taking TKI and proton pump inhibitors (PPI) or histamine-2 receptor antagonists (H2RA) were included as PPI and H2RA group respectively. Patients who did not take PPI or H2RA were classified as non-gastric acid suppressant (AS) users. The primary outcome was the progression-free survival (PFS).
Result & Outcome :
Among 249 patients, 59 and 63 patients were taking PPI and H2RA respectively while 127 patients were non-AS users. Median PFS was 11.7, 12.9 and 14.5 months respectively in non-AS, PPI and H2RA groups, which were not significantly different from each other (p = 0.231). There was no significant difference in OS (17.1 vs 16.2 vs 20.4 months for non-AS, PPI and H2RA respectively, p = 0.062). Adverse effects were not different from each group except more grade 2 skin rash in non-AS group (21.3% vs 8.6% in PPI vs 20.6% in H2RA, p = 0.042).
Co-location with:
