Concomitant administration of an antacid with erlotinib reportedly impairs the solubility of the film coating on erlotinib tablets and reduces its area under the curve, and thus the decrease in therapeutic effect is of concern. However the actual effect of concomitant administration on therapeutic outcome has not been studied. In this retrospective study 10 lung cancer patients who started erlotinib therapy at Shizuoka Cancer Center between January 2008 and March 2013 were divided into two groups, one with concomitant use of a proton pump inhibitor or H2 receptor antagonist (antacid group) and the other without (no antacid group). Data such as progression-free survival and overall survival extracted from electronic medical records were compared between the two groups. Among 10 subjects, 53 received an antacid agent while 5 did not. The median progression-free survival was 80 days in the antacid group while it was 8 days in the no antacid group the difference was not statistically sinificant (log-rank test, P= 0.59). The median overall survival was 178 days in the antacid group while it was 268 days in the no antacid group similarly the difference was not statistically significant (log-rank test, P= 0.25). Differences in progression-free survival and overall survival between the two groups were not signifcant when they were subdivided into EGFR mutation-positive subgroups EGFR mutation-negative subgroups and subgroups with a past history of gefitinib therapy. Taken together an antacid agent can be used concomitantly with erlotinib without affecting therapeutic outcomes in patients who require an antacid agent because of a past history of peptic ulcer or concomitant use of a non-steroidal anti-inflammatory drug
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