Concomitant administration of an antacid with erlotinib therapy: Its effect on therapeutic outcomes in lung cancer patients

• Autores: Rei Tanaka, Hiroshi Ishikawa, Michihiro Shino, Toshiak Takahashi
• Localización: European journal of clinical pharmacy: atención farmacéutica, ISSN 2385-409X, Vol. 17, Nº. 4, 2015, págs. 4-4
• Idioma: inglés
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• Resumen

  • 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 17􀀚8 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