Abstract 202P
Background
Prior reports indicate that statins and proton-pump inhibitors (PPI) have the capability to modulate host immune responses and gut microbiota in cancer and to affect the responses to immune checkpoint inhibitors (ICI). This study aimed to assess the effect of statins and PPI on the outcomes of ICI in patients with advanced hepatocellular carcinoma (HCC).
Methods
This retrospective analysis was conducted using data from electronic records of patients with HCC undergoing ICI-based treatment at our tertiary center. Patients were classified according to their use of PPI or statins to compare overall survival (OS), progression-free survival (PFS), and safety of immunotherapy.
Results
152 patients with HCC treated with ICI were included. Most of these patients received atezolizumab and bevacizumab (n=62.5%). 86 patients were treated with PPI and 35 patients with statins. The clinical outcome in PPI-treated patients did not differ from that of patients who did not receive PPIs (mOS were 19.8 and 23.6 months respectively; HR 1.11, [95% CI: 0.71-1.74], p=0.65; PFS were 7.0 and 5.2 months respectively; HR 1.00, [95% CI: 0.66-1.52], p=0.9971). Both groups also showed a similar incidence of immune-related adverse events (irAEs) (25.6% vs 30.3%, OR, 0.79 [95% CI: 0.38-1.60], p=0.58) and of gastrointestinal (GI) bleeding (8.1% vs 7.6%, OR, 1.08 [95% CI: 0.35-3.16], p>0.99). Likewise, outcomes were not statistically different in patients with or without statins, with an mOS of 10.8 months in the statin group vs 23.3 in the no-statin group (HR 1.30 [95% CI: 0.74-2.30], p=0.33), and mPFS of 6.4 months versus 6.8 months (HR, 0.96 [95% CI: 0.59 to 1.56], p=0.86). The two groups showed similar incidences of irAEs (25.7% vs 28.2%, OR 0.88 [95% CI: 0.37-2.10], p=0.83) and GI bleeding episodes (5.7% vs 8.6%, OR, 0.65 [95% CI: 0.14-2.59], p=0.73).
Conclusions
The findings of this preliminary analysis failed to confirm the hypothesis that treatment with statins or PPI adversely affects the outcome or the safety of patients with HCC treated with ICI-based therapies.
Legal entity responsible for the study
University Hospital LMU Munich.
Funding
Has not received any funding.
Disclosure
A.B. Philipp: Financial Interests, Personal, Invited Speaker: Falk Foundation; Financial Interests, Personal, Training: Roche. F.P. Reiter: Financial Interests, Personal, Invited Speaker: Falk Foundation, AbbVie, Gilead, Ipsen, AstraZeneca, Roche, Novartis. A. Geier: Financial Interests, Personal, Advisory Board: AbbVie, Alexion, Bayer, BMS, CSL, Behring, Eisai, Gilead, Heel, Intercept, Ipsen, Merz, MSD, Novartis, Pfizer, Roche, Sanofi-Aventis, Sequana; Financial Interests, Personal, Invited Speaker: Advanz. D.C. Rössler: Financial Interests, Personal, Invited Speaker: Eisai. E.N. De Toni: Financial Interests, Personal, Advisory Board: AstraZeneca, Bayer, BMS, Eisai, Eli Lilly & Co, Pfizer, Ipsen, Roche; Financial Interests, Personal, Other, Travel: Arqule, AstraZeneca, BMS, Bayer, Celsion, Roche; Financial Interests, Personal, Invited Speaker: BMS, Falk; Financial Interests, Institutional, Research Grant: Arqule, AstraZeneca, BMS, Bayer, Eli Lilly, Roche; Financial Interests, Personal, Full or part-time Employment: Boehringer-Ingelheim. N. Ben Khaled: Non-Financial Interests, Personal and Institutional, Training: Eisai; Financial Interests, Personal and Institutional, Invited Speaker: Falk, AstraZeneca. All other authors have declared no conflicts of interest.