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Concomitant medications during immune checkpoint blockage in cancer patients: Novel insights in this emerging clinical scenario.
Crit Rev Oncol Hematol. 2019 Oct; 142:26-34.CR

Abstract

The use of immune checkpoint inhibitors (ICIs) in cancer patients is rapidly growing. However, the potential impact of some widely used concomitant medications is still largely unclear. Emerging data suggest that gut microbiota may affect the efficacy of ICIs, leading to the hypothesis that concurrent antibiotics and proton pump inhibitors use could have a detrimental effect. In addition, steroid use might potentially impair the activity of immunotherapy, due its known immunosuppressive effects, and some safety concerns have been raised in patients receiving commonly used vaccination during ICIs. However, all randomized trials evaluating ICIs consistently excluded patients receiving high corticosteroid doses and data regarding other concomitant medications are lacking. Recently, several retrospective studies have tried to address this unmet medical need. Herein we discuss the latest evidence on the influence of these medications, critically analyzing the data reported so far and the possible implications in our clinical practice.

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Publisher Full Text (DOI)

Authors+Show Affiliations

Rossi G
Lung Cancer Unit-Ospedale Policlinico San Martino-Genova, Italy.
Pezzuto A
Cardiovascular and Respiratory Science, S. Andrea Hospital- Sapienza University Rome, Italy.
Sini C
Oncologia Medica e CPDO ASSL di Olbia-ATS Sardegna, Italy.
Tuzi A
ASST Sette Laghi, UO Oncologia, Varese, Italy.
Citarella F
Oncology Department, University Campus Bio-Medico Rome, Italy.
McCusker MG
University of Maryland Greenebaum Comprehensive Cancer Center, University of Maryland Medical Center, Baltimore, MD 21201, United States.
Nigro O
ASST Sette Laghi, UO Oncologia, Varese, Italy.
Tanda E
Skin Cancer Unit-Ospedale Policlinico San Martino-Genova, Italy.
Russo A
University of Maryland Greenebaum Comprehensive Cancer Center, University of Maryland Medical Center, Baltimore, MD 21201, United States; Medical Oncology Unit A.O. Papardo & Department of Human Pathology, University of Messina, Italy. Electronic address: alessandro-russo@alice.it.

MeSH

AnimalsAntineoplastic Agents, ImmunologicalB7-H1 AntigenCTLA-4 AntigenFemaleHumansImmunotherapyMaleNeoplasms

Pub Type(s)

Journal Article
Review

Language

eng

PubMed ID

31352168

Citation

Rossi, Giovanni, et al. "Concomitant Medications During Immune Checkpoint Blockage in Cancer Patients: Novel Insights in This Emerging Clinical Scenario." Critical Reviews in Oncology/hematology, vol. 142, 2019, pp. 26-34.
Rossi G, Pezzuto A, Sini C, et al. Concomitant medications during immune checkpoint blockage in cancer patients: Novel insights in this emerging clinical scenario. Crit Rev Oncol Hematol. 2019;142:26-34.
Rossi, G., Pezzuto, A., Sini, C., Tuzi, A., Citarella, F., McCusker, M. G., Nigro, O., Tanda, E., & Russo, A. (2019). Concomitant medications during immune checkpoint blockage in cancer patients: Novel insights in this emerging clinical scenario. Critical Reviews in Oncology/hematology, 142, 26-34. https://doi.org/10.1016/j.critrevonc.2019.07.005
Rossi G, et al. Concomitant Medications During Immune Checkpoint Blockage in Cancer Patients: Novel Insights in This Emerging Clinical Scenario. Crit Rev Oncol Hematol. 2019;142:26-34. PubMed PMID: 31352168.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Concomitant medications during immune checkpoint blockage in cancer patients: Novel insights in this emerging clinical scenario. AU - Rossi,Giovanni, AU - Pezzuto,Aldo, AU - Sini,Claudio, AU - Tuzi,Alessandro, AU - Citarella,Fabrizio, AU - McCusker,Michael G, AU - Nigro,Olga, AU - Tanda,Enrica, AU - Russo,Alessandro, Y1 - 2019/07/22/ PY - 2019/05/07/received PY - 2019/06/30/revised PY - 2019/07/03/accepted PY - 2019/7/29/pubmed PY - 2019/11/28/medline PY - 2019/7/29/entrez KW - Antibiotics KW - Immune checkpoint inhibitors KW - Proton pump inhibitors KW - Steroid KW - Vaccine SP - 26 EP - 34 JF - Critical reviews in oncology/hematology JO - Crit Rev Oncol Hematol VL - 142 N2 - The use of immune checkpoint inhibitors (ICIs) in cancer patients is rapidly growing. However, the potential impact of some widely used concomitant medications is still largely unclear. Emerging data suggest that gut microbiota may affect the efficacy of ICIs, leading to the hypothesis that concurrent antibiotics and proton pump inhibitors use could have a detrimental effect. In addition, steroid use might potentially impair the activity of immunotherapy, due its known immunosuppressive effects, and some safety concerns have been raised in patients receiving commonly used vaccination during ICIs. However, all randomized trials evaluating ICIs consistently excluded patients receiving high corticosteroid doses and data regarding other concomitant medications are lacking. Recently, several retrospective studies have tried to address this unmet medical need. Herein we discuss the latest evidence on the influence of these medications, critically analyzing the data reported so far and the possible implications in our clinical practice. SN - 1879-0461 UR - https://www.unboundmedicine.com/medline/citation/31352168/Concomitant_medications_during_immune_checkpoint_blockage_in_cancer_patients:_Novel_insights_in_this_emerging_clinical_scenario_ DB - PRIME DP - Unbound Medicine ER -