Common Meds Linked to Reduced Immunotherapy Benefit in Lung Cancer Trial

In the PACIFIC trial, durvalumab following chemoradiotherapy significantly improved survival in patients with unresectable stage III non-small cell lung cancer, and became the standard of care in this setting.In a post-hoc analysis of the trial, exposure to proton pump inhibitors was associated with worse survival among patients in the durvalumab group.Exposure to antibiotics was also associated with shorter progression-free survival compared with no exposure, but not overall survival.

Exposure to proton pump inhibitors (PPIs) was associated with worse progression-free survival (PFS) and overall survival (OS) in patients with locally advanced non-small cell lung cancer (NSCLC) who were treated with durvalumab (Imfinzi) after chemoradiotherapy, according to a post-hoc analysis of the PACIFIC trial.

Among patients treated with durvalumab, baseline exposure to PPIs was associated with shorter PFS (median 9.4 vs 17.2 months, HR 1.57, 95% CI 1.28-1.93, P<0.0001) and OS (median 33 vs 57.9 months, HR 1.66, 95% CI 1.30-2.13, P<0.0001) compared with no exposure, reported Alessio Cortellini, MD, PhD, of Imperial College London, and colleagues.

Meanwhile, baseline exposure to antibiotics was associated with shorter PFS (9.2 vs 15.6 months, HR 1.50, 95% CI 1.08-2.10, P=0.016) compared with no exposure, but there was no significant change in OS (37.7 vs 49.2 months, HR 1.33, 95% CI 0.90-1.97, P=0.16), they noted in Lancet Oncology.