Jessica A. Steadman, Ahmer Sultan, Courtney N. Day, Marie A. Parish, Susanne G. Warner, Michael L. Kendrick, Mark J. Truty, Zhaohui Jin, Cornelius A. Thiels
{"title":"Impact of proton pump inhibitors on pathologic response rates following fluoropyrimidine‐based neoadjuvant chemotherapy in pancreatic cancer patients","authors":"Jessica A. Steadman, Ahmer Sultan, Courtney N. Day, Marie A. Parish, Susanne G. Warner, Michael L. Kendrick, Mark J. Truty, Zhaohui Jin, Cornelius A. Thiels","doi":"10.1002/jso.27837","DOIUrl":null,"url":null,"abstract":"BackgroundProton pump inhibitors (PPIs) negatively impact fluoropyrimidine‐based chemotherapy efficacy in colorectal cancer. This study assessed PPI impact on major pathologic response (mPR) rates of pancreatic adenocarcinoma (PDAC) patients receiving fluoropyrimidine‐based chemotherapy.MethodsAn institutional retrospective review of resected PDAC patients receiving neoadjuvant fluoropyrimidine‐based chemotherapy (98% FOLFIRINOX) from 2011 to 2021 was conducted. Outcomes were stratified by use or nonuse of PPIs within 6 months of neoadjuvant chemotherapy initiation. Primary outcome was mPR defined as complete or near complete response.ResultsAmong 540 patients included, the median age was 64 (IQR: 60–70) years, 297 (55%) were male, and 202 (37%) were PPI users. 170 (31%) patients had mPR with similar rates among PPI users and nonusers (29% vs. 33%, <jats:italic>p</jats:italic> = 0.38). No difference in mPR was seen between PPI users and nonusers receiving chemoradiation (35% vs. 36%, <jats:italic>p</jats:italic> = 0.89) or ≥8 cycles of NAC (33% vs. 36%, <jats:italic>p</jats:italic> = 0.55). Median OS for PPI users was 30.9 versus 31.7 months for nonusers (<jats:italic>p</jats:italic> = 0.62). On multivariable analysis, PPI therapy was not associated with decreased survival.ConclusionPPI usage did not significantly influence mPR or OS following neoadjuvant fluoropyrimidine‐based chemotherapy in resected PDAC patients. Further analysis of all patients, not just those who underwent resection, is required.","PeriodicalId":17111,"journal":{"name":"Journal of Surgical Oncology","volume":null,"pages":null},"PeriodicalIF":2.0000,"publicationDate":"2024-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Surgical Oncology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1002/jso.27837","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"ONCOLOGY","Score":null,"Total":0}
引用次数: 0
Abstract
BackgroundProton pump inhibitors (PPIs) negatively impact fluoropyrimidine‐based chemotherapy efficacy in colorectal cancer. This study assessed PPI impact on major pathologic response (mPR) rates of pancreatic adenocarcinoma (PDAC) patients receiving fluoropyrimidine‐based chemotherapy.MethodsAn institutional retrospective review of resected PDAC patients receiving neoadjuvant fluoropyrimidine‐based chemotherapy (98% FOLFIRINOX) from 2011 to 2021 was conducted. Outcomes were stratified by use or nonuse of PPIs within 6 months of neoadjuvant chemotherapy initiation. Primary outcome was mPR defined as complete or near complete response.ResultsAmong 540 patients included, the median age was 64 (IQR: 60–70) years, 297 (55%) were male, and 202 (37%) were PPI users. 170 (31%) patients had mPR with similar rates among PPI users and nonusers (29% vs. 33%, p = 0.38). No difference in mPR was seen between PPI users and nonusers receiving chemoradiation (35% vs. 36%, p = 0.89) or ≥8 cycles of NAC (33% vs. 36%, p = 0.55). Median OS for PPI users was 30.9 versus 31.7 months for nonusers (p = 0.62). On multivariable analysis, PPI therapy was not associated with decreased survival.ConclusionPPI usage did not significantly influence mPR or OS following neoadjuvant fluoropyrimidine‐based chemotherapy in resected PDAC patients. Further analysis of all patients, not just those who underwent resection, is required.
期刊介绍:
The Journal of Surgical Oncology offers peer-reviewed, original papers in the field of surgical oncology and broadly related surgical sciences, including reports on experimental and laboratory studies. As an international journal, the editors encourage participation from leading surgeons around the world. The JSO is the representative journal for the World Federation of Surgical Oncology Societies. Publishing 16 issues in 2 volumes each year, the journal accepts Research Articles, in-depth Reviews of timely interest, Letters to the Editor, and invited Editorials. Guest Editors from the JSO Editorial Board oversee multiple special Seminars issues each year. These Seminars include multifaceted Reviews on a particular topic or current issue in surgical oncology, which are invited from experts in the field.