The Impact of Concomitant Medications on the Overall Survival of Patients Treated with Systemic Therapy for Advanced or Metastatic Renal Cell Carcinoma: A Systematic Review and Meta-analysis
Jazyk angličtina Země Spojené státy americké Médium print-electronic
Typ dokumentu časopisecké články, systematický přehled, metaanalýza
PubMed
39546952
DOI
10.1016/j.clgc.2024.102237
PII: S1558-7673(24)00207-6
Knihovny.cz E-zdroje
- Klíčová slova
- Chemotherapy, Concomitant medications metastatic renal cell carcinoma, Immune checkpoint inhibitors,
- MeSH
- analýza přežití MeSH
- beta blokátory terapeutické užití MeSH
- inhibitory kontrolních bodů terapeutické užití MeSH
- inhibitory proteinkinas terapeutické užití MeSH
- inhibitory protonové pumpy terapeutické užití aplikace a dávkování MeSH
- karcinom z renálních buněk * farmakoterapie mortalita sekundární MeSH
- lékové interakce MeSH
- lidé MeSH
- nádory ledvin * farmakoterapie mortalita patologie MeSH
- statiny terapeutické užití MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- metaanalýza MeSH
- systematický přehled MeSH
- Názvy látek
- beta blokátory MeSH
- inhibitory kontrolních bodů MeSH
- inhibitory proteinkinas MeSH
- inhibitory protonové pumpy MeSH
- statiny MeSH
Although immune checkpoint inhibitors (ICI) and/or tyrosine kinase inhibitors (TKI) are the standard treatment of advanced unresectable or metastatic renal cell carcinoma (RCC), the impact of concomitant medications remains unclear. We aimed to evaluate the impact of concomitant medications on survival outcomes in patients treated with systemic therapy for advanced unresectable or metastatic RCC. In August 2024, PubMed, Scopus, and Web of Science were queried for studies evaluating concomitant medications in patients with advanced unresectable or metastatic RCC (PROSPERO: CRD42024573252). The primary outcome was overall survival (OS). A fixed- or random-effects model was used for meta-analysis according to heterogeneity. We identified 22 eligible studies (5 prospective and 17 retrospective) comprising 16,072 patients. Concomitant medications included proton pump inhibitors (PPI) (n = 3959), antibiotics (n = 571), statins (n = 5466), renin-angiotensin system inhibitors (RASi) (n = 6615), and beta-blockers (n = 1964). Both concomitant PPI and antibiotics were significantly associated with worse OS in patients treated with ICI (PPI: HR: 1.22, P = .01, and antibiotics: HR: 2.09, P < .001). Concomitant statins, RASi, or beta-blocker were significantly associated with improved OS in patients treated with TKI (statins: HR: 0.81, P = .03, RASi: HR: 0.63, P < .001, beta-blocker: HR: 0.69, P < .001, respectively). In patients treated with ICI, RASi was significantly associated with improved OS (HR: 0.64, P = .02). Concomitant use of antibiotics or PPI with ICI can reduce its oncologic efficacy. Conversely, concomitant statins, RASi, or beta-blockers can enhance the oncologic efficacy of TKI. When initiating systemic therapy for metastatic RCC, it may be important for clinicians to assess baseline co-medications and recognize their possible positive or negative effects.
Citace poskytuje Crossref.org
