JNCCN:质子泵抑制剂(PPI)可能降低结直肠癌患者的生存

2021-05-11 yd2015 MedSci原创

质子泵抑制剂(PPI)是临床上常用的药物。非癌人群观察性研究中发现,长期服用PPI可出现严重的不良后果,比如增加全因死亡率,心血管疾病,肾脏疾病,低镁血症以及肿瘤等。体内实验发现PPI似乎可有增强某些

质子泵抑制剂(PPI)是临床上常用的药物。非癌人群观察性研究中发现,长期服用PPI可出现严重的不良后果,比如增加全因死亡率,血管疾病,肾脏疾病,低镁血症以及肿瘤等。体内实验发现PPI似乎可有增强某些抗肿瘤药物的活性。但是,其中的机制不明确。也有观察性和回顾性研究发现,PPI可以降低卡培他滨的疗效,药代动力学以及体内实验也未能解析两者的关系。

因此,来自澳大利亚的研究团队,在Journal of The National Comprehensive Cancer Network (JNCCN) 杂志发表了一项研究数据,评估PPI与氟尿嘧啶治疗为基础的晚期结直肠癌的生存关系。

该研究主要为随机对照研究的二次分析,纳入了6项研究,共5594例患者,其中902例患者使用PPI(使用PPI定义为:自临床实验开始服用任何PPI至少7天)。主要研究总生存(OS),无进展生存(PFS),以及亚组分析,如卡培他滨或5-氟尿嘧啶等。使用随机效应模型计算HR和95%CI。

研究数据显示,PPI 使用跟结直肠癌患者较差的OS相关 (pooled HR, 1.20; 95% CI, 1.03–1.40; P=0.02; I 2 = 69%);

                      OS分析

同样, PPI 使用跟结直肠癌患者较差的PFS相关 (overall pooledHR, 1.20; 95% CI, 1.05–1.37; P=0.009; I 2 = 65%) 。

             PFS分析

而亚组分析发现PPI的使用在各治疗亚组中的生存关系跟与总体人群中相似。

                  亚组分析

综上,PPI的使用跟氟尿嘧啶为基础治疗的晚期结直肠癌患者较差预后有关。当然,这个需要更进一步的研究。但是也同时提醒我们临床医生,对于这部分患者需要谨慎使用PPI。

原始出处:

Ganessan Kichenadasse, MBBS, FRACP, John O. Miners, et al. Proton Pump Inhibitors and Survival in Patients With Colorectal Cancer Receiving Fluoropyrimidine-Based Chemotherapy. JNCCN. Online Publication Date: 05 May 2021. DOI: https://doi.org/10.6004/jnccn.2020.7670.

版权声明:
本网站所有内容来源注明为“梅斯医学”或“MedSci原创”的文字、图片和音视频资料,版权均属于梅斯医学所有。非经授权,任何媒体、网站或个人不得转载,授权转载时须注明来源为“梅斯医学”。其它来源的文章系转载文章,或“梅斯号”自媒体发布的文章,仅系出于传递更多信息之目的,本站仅负责审核内容合规,其内容不代表本站立场,本站不负责内容的准确性和版权。如果存在侵权、或不希望被转载的媒体或个人可与我们联系,我们将立即进行删除处理。
在此留言
评论区 (5)
#插入话题
  1. [GetPortalCommentsPageByObjectIdResponse(id=1852653, encodeId=1a10185265318, content=<a href='/topic/show?id=f0a254918f0' target=_blank style='color:#2F92EE;'>#抑制剂#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=51, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=54918, encryptionId=f0a254918f0, topicName=抑制剂)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=44a360, createdName=jklm09, createdTime=Sat Mar 19 22:25:58 CST 2022, time=2022-03-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1667390, encodeId=5d48166e3900c, content=<a href='/topic/show?id=03ab923565b' target=_blank style='color:#2F92EE;'>#质子泵#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=45, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=92356, encryptionId=03ab923565b, topicName=质子泵)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=761326143554, createdName=shenxlcyp, createdTime=Thu Dec 30 13:25:58 CST 2021, time=2021-12-30, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=965479, encodeId=ceff9654e903, content=跟踪学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=65, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f18e5463974, createdName=ms7000000414344418, createdTime=Fri May 14 11:02:20 CST 2021, time=2021-05-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1320177, encodeId=679313201e75d, content=<a href='/topic/show?id=c806125e30b' target=_blank style='color:#2F92EE;'>#NCCN#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=40, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=12573, encryptionId=c806125e30b, topicName=NCCN)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=e572480, createdName=旅苦化文_208, createdTime=Thu May 13 01:25:58 CST 2021, time=2021-05-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1453506, encodeId=60701453506c7, content=<a href='/topic/show?id=098ee8679ad' target=_blank style='color:#2F92EE;'>#结直肠#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=44, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=78679, encryptionId=098ee8679ad, topicName=结直肠)], attachment=null, authenticateStatus=null, createdAvatar=/v1.0.0/img/user_icon.png, createdBy=9ace5575596, createdName=crystal0564, createdTime=Thu May 13 01:25:58 CST 2021, time=2021-05-13, status=1, ipAttribution=)]
    2022-03-19 jklm09
  2. [GetPortalCommentsPageByObjectIdResponse(id=1852653, encodeId=1a10185265318, content=<a href='/topic/show?id=f0a254918f0' target=_blank style='color:#2F92EE;'>#抑制剂#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=51, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=54918, encryptionId=f0a254918f0, topicName=抑制剂)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=44a360, createdName=jklm09, createdTime=Sat Mar 19 22:25:58 CST 2022, time=2022-03-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1667390, encodeId=5d48166e3900c, content=<a href='/topic/show?id=03ab923565b' target=_blank style='color:#2F92EE;'>#质子泵#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=45, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=92356, encryptionId=03ab923565b, topicName=质子泵)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=761326143554, createdName=shenxlcyp, createdTime=Thu Dec 30 13:25:58 CST 2021, time=2021-12-30, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=965479, encodeId=ceff9654e903, content=跟踪学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=65, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f18e5463974, createdName=ms7000000414344418, createdTime=Fri May 14 11:02:20 CST 2021, time=2021-05-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1320177, encodeId=679313201e75d, content=<a href='/topic/show?id=c806125e30b' target=_blank style='color:#2F92EE;'>#NCCN#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=40, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=12573, encryptionId=c806125e30b, topicName=NCCN)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=e572480, createdName=旅苦化文_208, createdTime=Thu May 13 01:25:58 CST 2021, time=2021-05-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1453506, encodeId=60701453506c7, content=<a href='/topic/show?id=098ee8679ad' target=_blank style='color:#2F92EE;'>#结直肠#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=44, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=78679, encryptionId=098ee8679ad, topicName=结直肠)], attachment=null, authenticateStatus=null, createdAvatar=/v1.0.0/img/user_icon.png, createdBy=9ace5575596, createdName=crystal0564, createdTime=Thu May 13 01:25:58 CST 2021, time=2021-05-13, status=1, ipAttribution=)]
  3. [GetPortalCommentsPageByObjectIdResponse(id=1852653, encodeId=1a10185265318, content=<a href='/topic/show?id=f0a254918f0' target=_blank style='color:#2F92EE;'>#抑制剂#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=51, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=54918, encryptionId=f0a254918f0, topicName=抑制剂)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=44a360, createdName=jklm09, createdTime=Sat Mar 19 22:25:58 CST 2022, time=2022-03-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1667390, encodeId=5d48166e3900c, content=<a href='/topic/show?id=03ab923565b' target=_blank style='color:#2F92EE;'>#质子泵#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=45, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=92356, encryptionId=03ab923565b, topicName=质子泵)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=761326143554, createdName=shenxlcyp, createdTime=Thu Dec 30 13:25:58 CST 2021, time=2021-12-30, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=965479, encodeId=ceff9654e903, content=跟踪学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=65, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f18e5463974, createdName=ms7000000414344418, createdTime=Fri May 14 11:02:20 CST 2021, time=2021-05-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1320177, encodeId=679313201e75d, content=<a href='/topic/show?id=c806125e30b' target=_blank style='color:#2F92EE;'>#NCCN#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=40, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=12573, encryptionId=c806125e30b, topicName=NCCN)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=e572480, createdName=旅苦化文_208, createdTime=Thu May 13 01:25:58 CST 2021, time=2021-05-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1453506, encodeId=60701453506c7, content=<a href='/topic/show?id=098ee8679ad' target=_blank style='color:#2F92EE;'>#结直肠#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=44, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=78679, encryptionId=098ee8679ad, topicName=结直肠)], attachment=null, authenticateStatus=null, createdAvatar=/v1.0.0/img/user_icon.png, createdBy=9ace5575596, createdName=crystal0564, createdTime=Thu May 13 01:25:58 CST 2021, time=2021-05-13, status=1, ipAttribution=)]
    2021-05-14 ms7000000414344418

    跟踪学习

    0

  4. [GetPortalCommentsPageByObjectIdResponse(id=1852653, encodeId=1a10185265318, content=<a href='/topic/show?id=f0a254918f0' target=_blank style='color:#2F92EE;'>#抑制剂#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=51, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=54918, encryptionId=f0a254918f0, topicName=抑制剂)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=44a360, createdName=jklm09, createdTime=Sat Mar 19 22:25:58 CST 2022, time=2022-03-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1667390, encodeId=5d48166e3900c, content=<a href='/topic/show?id=03ab923565b' target=_blank style='color:#2F92EE;'>#质子泵#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=45, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=92356, encryptionId=03ab923565b, topicName=质子泵)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=761326143554, createdName=shenxlcyp, createdTime=Thu Dec 30 13:25:58 CST 2021, time=2021-12-30, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=965479, encodeId=ceff9654e903, content=跟踪学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=65, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f18e5463974, createdName=ms7000000414344418, createdTime=Fri May 14 11:02:20 CST 2021, time=2021-05-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1320177, encodeId=679313201e75d, content=<a href='/topic/show?id=c806125e30b' target=_blank style='color:#2F92EE;'>#NCCN#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=40, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=12573, encryptionId=c806125e30b, topicName=NCCN)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=e572480, createdName=旅苦化文_208, createdTime=Thu May 13 01:25:58 CST 2021, time=2021-05-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1453506, encodeId=60701453506c7, content=<a href='/topic/show?id=098ee8679ad' target=_blank style='color:#2F92EE;'>#结直肠#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=44, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=78679, encryptionId=098ee8679ad, topicName=结直肠)], attachment=null, authenticateStatus=null, createdAvatar=/v1.0.0/img/user_icon.png, createdBy=9ace5575596, createdName=crystal0564, createdTime=Thu May 13 01:25:58 CST 2021, time=2021-05-13, status=1, ipAttribution=)]
  5. [GetPortalCommentsPageByObjectIdResponse(id=1852653, encodeId=1a10185265318, content=<a href='/topic/show?id=f0a254918f0' target=_blank style='color:#2F92EE;'>#抑制剂#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=51, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=54918, encryptionId=f0a254918f0, topicName=抑制剂)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=44a360, createdName=jklm09, createdTime=Sat Mar 19 22:25:58 CST 2022, time=2022-03-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1667390, encodeId=5d48166e3900c, content=<a href='/topic/show?id=03ab923565b' target=_blank style='color:#2F92EE;'>#质子泵#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=45, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=92356, encryptionId=03ab923565b, topicName=质子泵)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=761326143554, createdName=shenxlcyp, createdTime=Thu Dec 30 13:25:58 CST 2021, time=2021-12-30, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=965479, encodeId=ceff9654e903, content=跟踪学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=65, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f18e5463974, createdName=ms7000000414344418, createdTime=Fri May 14 11:02:20 CST 2021, time=2021-05-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1320177, encodeId=679313201e75d, content=<a href='/topic/show?id=c806125e30b' target=_blank style='color:#2F92EE;'>#NCCN#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=40, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=12573, encryptionId=c806125e30b, topicName=NCCN)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=e572480, createdName=旅苦化文_208, createdTime=Thu May 13 01:25:58 CST 2021, time=2021-05-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1453506, encodeId=60701453506c7, content=<a href='/topic/show?id=098ee8679ad' target=_blank style='color:#2F92EE;'>#结直肠#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=44, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=78679, encryptionId=098ee8679ad, topicName=结直肠)], attachment=null, authenticateStatus=null, createdAvatar=/v1.0.0/img/user_icon.png, createdBy=9ace5575596, createdName=crystal0564, createdTime=Thu May 13 01:25:58 CST 2021, time=2021-05-13, status=1, ipAttribution=)]

相关资讯

Radiology:这一技术,让结直肠癌肺转移患者看到希望!

结直肠癌(CRC)是世界范围内最常见的恶性肿瘤之一,约有10%至20%的患者出现肺部转移。

Br J Cancer:循环肿瘤细胞(CTC)和细胞游离DNA(cfDNA):转移性结直肠癌的预后靶标

精准医疗是一种新兴的疾病治疗和预防方法,其考虑了基因、环境和生活方式的个体差异。

Clin Cancer Res:瑞戈非尼联合奥维单抗治疗微卫星稳定的晚期结直肠癌

在临床前模型中,瑞戈非尼与免疫检查点抑制表现出协同作用。本研究旨在验证瑞戈非尼与免疫检查点抑制剂奥维单抗联合治疗晚期结直肠癌的疗效和安全性

2021年结直肠癌分子检测高通量测序中国专家共识发布,要点一览!

从临床和实验室,立足于建立行业规范和标准。

Br J Cancer:老年医学干预(CGA)可改善老年结直肠癌患者的化疗预后

结直肠癌(CRC)死亡率在过去十年中有所下降,特别是在年轻患者中尤为显著。

BMJ:结直肠息肉或结直肠癌患者的一级亲属要早期筛查结直肠癌

结直肠息肉患者的兄弟姐妹和子女患结直肠息肉的风险增加,特别是当一个以上的一级亲属或60岁之前诊断出息肉时。早发性结直肠癌的风险增加更为突出,并与结直肠癌家族史相关