Effect of Concomitant pH-Elevating Medications with Pazopanib on Progression-Free Survival and Overall Survival in Patients with Metastatic Renal Cell Carcinoma

The Oncologist
Renee K McAlisterDavid D Chism

Abstract

Pazopanib is an oral tyrosine-kinase inhibitor that is approved by the U.S. Food and Drug Administration for treatment of metastatic renal cell carcinoma (mRCC). Pharmacokinetic data have shown that concomitant administration of pazopanib and esomeprazole, a proton pump inhibitor (PPI), leads to decreased area under the curve and thus decreased exposure of pazopanib by 40%. Despite the pharmacokinetic data published to date, the clinical significance and impact on patient outcomes resulting from decreased pazopanib exposure remains unknown. In this retrospective, observational, cohort study, 90 patients with mRCC who either received pazopanib in combination with a PPI or histamine 2 receptor antagonist (H2RA; concurrent PPI/H2RA group) or who did not take concurrent pH-elevating medications (no PPI/H2RA group) were compared to determine if there was an impact on progression-free survival (PFS), the primary endpoint, and secondary endpoints, overall survival (OS) and safety. The differences between the PFS of 9.0 months and OS of 28.0 months for the concomitant PPI/H2RA group versus 11.0 months and 30.1 months, respectively, for the no PPI/H2RA group were not statistically significant. Rates of adverse events were similar betwee...Continue Reading

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Citations

May 8, 2019·BMJ Case Reports·Carolina PalmelaAlexandre Oliveira Ferreira
Nov 30, 2019·British Journal of Clinical Pharmacology·Kim WesterdijkUNKNOWN Dutch Pharmacology and Oncology Group (DPOG)
Jan 15, 2020·European Journal of Clinical Pharmacology·Camille AzamFlorent Puisset
Jan 12, 2021·International Journal of Cancer. Journal International Du Cancer·Stefanie D KrensNielka P van Erp
Nov 5, 2019·Biochimica Et Biophysica Acta. Reviews on Cancer·Urvi H GalaRobert O Williams
Oct 23, 2020·International Journal of Clinical Oncology·Hyun Jin SongIn-Hyuk Ha

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