New evidence against the co-administration of proton pump inhibitors and certain cancer therapies has recently been published.
- Proton pump inhibitors (PPIs) reduce the absorption of certain tyrosine kinase inhibitors (TKIs), used to treat lung cancers or sarcomas.
- These drugs also reduce the diversity of the microbiota, thus reducing the effectiveness of immunotherapies.
- According to researchers, PPIs can be replaced in most cases by antacids or H2 blockers.
16 million. This is the number of French people who took proton pump inhibitors (PPI) in 2019. These drugs are used to reduce the secretion of stomach acid. They are indicated in the management of gastroesophageal reflux disease (GERD) and peptic ulcers. “These treatments are widely used in cancer patients, despite accumulating data showing that they may impact the effectiveness of major anticancer drugs,” indicated a researcher from the Western Cancer Institute in Saint-Herblain and another working at the University of Washington.
In a recent study, scientists warned against co-administration of proton pump inhibitors and certain cancer treatments, which may have effects on patient survival. The cancer therapies in question are: tyrosine kinase inhibitors (TKIs), which are prescribed to treat lung cancers or sarcomas, and immune checkpoint inhibitors used in immunotherapy.
The effectiveness of cancer treatments decreases due to proton pump inhibitors
According to Jean-Luc Raouldigestive oncologist and author of the work, “Taking proton pump inhibitors with a certain number of anticancer drugs is a problem, since we will significantly reduce the effectiveness of the latter.” Indeed, in the work, the researchers indicate that by reducing gastric acidity, PPIs reduce the survival benefit of certain tyrosine kinase inhibitors (erlotinib, gefitinib and pazopanib), which need them for their absorption. Furthermore, the links between the microbiota, the immune system and the effectiveness of immunotherapy are “now obvious”just like changes in intestinal flora after PPI use.
“Numerous retrospective articles, including articles based on individual data from randomized studies, have demonstrated that patients treated with immune checkpoint inhibitors have a worse outcome (overall survival, progression-free survival and response rate ) when they received PPIs concomitantly, while there was no impact of such co-prescription in patients in the control groups, not treated with immunotherapy”, can we read in the research published in the journal Cancer Treatment Reviews.
Cancer: use “antacids or H2 blockers” instead of PPIs
In the conclusions, the authors emphasize the importance of taking good measures and warning patients and doctors of the impact of this drug interaction. “In patients who require acid suppression due to severe symptoms, the use of antacids or H2 blockers might be recommended”they concluded.