Renal cell cancer (RCC) is typically a disease of older adults, who often have comorbidities requiring the use of multiple concomitant medications. Even though the patients with metastatic RCC (mRCC) are often exposed to concomitant medications in parallel with anticancer agents, the impact of such co-medications remains insufficiently explored. The aim of this study was to investigate the impact of the use of proton pump inhibitors (PPIs) and/or cardiovascular medication on the outcomes of patients with mRCC receiving nivolumab. Clinical data of patients with mRCC treated with nivolumab monotherapy were retrospectively analyzed with a focus on the association between progression-free survival (PFS) or overall survival (OS) and the use of common co-medications including PPIs, acetylsalicylic acid, statins, and antihypertensives. In total, 343 patients with mRCC were included. The median PFS and OS were 4.8 (95% CI 3.9–6.0) and 15.5 (95% CI 10.7–19.6) months vs. 9.7 (95% CI 7.6–12.2) and 29.8 (95% CI 23.7–33.1) months (p < 0.001 and p < 0.001) for PPI users and non-users, respectively. In the Cox multivariate analysis, the use of PPIs remained a significant factor predicting both inferior PFS (HR = 1.870 [95% CI 1.440–2.428], p < 0.001) and OS (HR = 1.674 [95% CI 1.235–2.270], p = 0.001).). We did not find any impact of the basic classes of antihypertensive drugs, statins, or acetylsalicylic acid on the survival outcomes. Present study results demonstrate the negative impact of concomitant PPI use on PFS and OS, whereas neither statins nor antihypertensive medications had a significant impact on survival outcomes in patients with mRCC receiving nivolumab monotherapy.

• Klíčová slova
• Acetyl salicylic acid, Antihypertensives, Beta-blockers, Drug-drug interactions, Immunotherapy, Nivolumab, Proton pump inhibitors, Renal cell carcinoma, Statins,
• Publikační typ
• časopisecké články MeSH

BACKGROUND: Patients with metastatic renal cell carcinoma (mRCC) are often elderly and have various comorbidities, including cardiovascular diseases. Although these patients have extensive co-exposure to targeted therapy and cardiovascular drugs, the impact of this co-exposure on outcomes for patients with mRCC remains unclear. OBJECTIVE: Our objective was to evaluate the association between the use of cardiovascular medication and survival of patients with mRCC. METHODS: The study included 343 consecutive patients with mRCC treated with sunitinib or pazopanib in the first line. Clinical data obtained from the Renal Cell Carcinoma Information System (RENIS) clinical registry and hospital information systems were retrospectively analyzed. Progression-free survival (PFS) and overall survival (OS) were compared according to the use of common medications, including antihypertensives (i.e., β-blockers [BBs], angiotensin-converting enzyme inhibitors, angiotensin II receptor blockers, calcium channel blockers, and diuretics), acetylsalicylic acid (aspirin), statins, and proton pump inhibitors. RESULTS: The univariate Cox analysis evaluating the impact of the assessed comedications on patient survival revealed that only BBs were significantly associated with PFS (hazard ratio [HR] 0.533, p < 0.001) and OS (HR 0.641, p = 0.006). The median PFS and OS for users of BBs was 18.39 and 37.60 months versus 8.16 and 20.4 months for patients not using BBs (p < 0.001 and p < 0.001, respectively). The Cox multivariate analysis showed that the use of BBs was a significant factor for both PFS (HR 0.428, p = 0.001) and OS (HR 0.518, p = 0.001). CONCLUSIONS: The results of this retrospective study suggest that the use of BBs is associated with favorable outcomes for patients with mRCC treated with sunitinib or pazopanib in the first line.

• MeSH
• indazoly MeSH
• indoly farmakologie   terapeutické užití   MeSH
• karcinom z renálních buněk * farmakoterapie   MeSH
• kardiovaskulární látky * MeSH
• lidé MeSH
• nádory ledvin * farmakoterapie   MeSH
• přežití bez známek nemoci MeSH
• pyrimidiny MeSH
• pyrroly MeSH
• retrospektivní studie MeSH
• senioři MeSH
• sulfonamidy MeSH
• sunitinib farmakologie   terapeutické užití   MeSH
• výsledek terapie MeSH
• Check Tag
• lidé MeSH
• senioři MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH
• Názvy látek
• indazoly MeSH
• indoly MeSH
• kardiovaskulární látky * MeSH
• pazopanib MeSH Prohlížeč
• pyrimidiny MeSH
• pyrroly MeSH
• sulfonamidy MeSH
• sunitinib MeSH