High dose proton pump inhibitor (PPI) in association with first line chemotherapy improves overall survival in patients with metastatic breast cancer

Abstract

Event Abstract Back to Event High dose proton pump inhibitor (PPI) in association with first line chemotherapy improves overall survival in patients with metastatic breast cancer Xichun Hu1* 1 Fudan University Shanghai Cancer Center, China Background. This randomized phase II study (NCT01069081) was to investigate whether the efficacy of chemotherapy could be improved with the addition of PPI in patients with metastatic breast cancer (MBC). Methods. Patients enrolled were randomly assigned to three arms: Arm A, docetaxel 75 mg/m2 followed by cisplatin 75 mg/m2 on d4, repeated every 21 days with a maximum of 6 cycles; Arm B, the same chemotherapy preceded by three days esomeprazole (ESOM) 80 mg p.o. bid, beginning on d1 repeated weekly. Weekly intermittent administration of ESOM (3 days on 4 days off) was maintained up to a maximum of 66 weeks; Arm C, the same as Arm B with the only difference being dose of ESOM at 100 mg p.o. bid. The primary endpoint was time to progression (TTP). Secondary end points included ORR, overall survival (OS), and safety profile. Results. From Aug. 2009 to Aug. 2011, 100 women signed informed consent form and 94 patients were randomly assigned and underwent at least one injection of chemotherapy. Although one month improvement of median TTP was observed in patients who had taken ESOM comparing to those who not, it was not statistically significant (9.7 v 8.7 months, p>0.05). However, a significant OS difference was detected between patients with or without ESOM (p=0.039). No additional toxicity was observed with PPI. Conclusions. This is the first prospective randomized study to demonstrate antitumor effects of intermittent high dose PPI in patients with metastatic breast cancer, indicating a possible synergistic effect with chemotherapy. References Fais S, De Milito A, You H, Qin W. Targeting vacuolar H+-ATPases as a new strategy against cancer. Cancer Res 2007; 67: 10627-1063. De Milito A, Canese R, Marino ML et al. pH-dependent antitumor activity of proton pump inhibitors against human melanoma is mediated by inhibition of tumor acidity. Int J Cancer 2010; 127: 207-219. Keywords: Breast Neoplasms, treatment outcome, chemotherapy, chemotherapy resistance, acidity, metastatic breast cancer, Proton Pump Inhibitors Conference: 4th Annual Meeting of the International Society of Proton Dynamics in Cancer, Garching, Germany, 10 Oct - 12 Oct, 2013. Presentation Type: Abstract Topic: 9. Acidity as a target for antitumor therapy Citation: Hu X (2014). High dose proton pump inhibitor (PPI) in association with first line chemotherapy improves overall survival in patients with metastatic breast cancer. Front. Pharmacol. Conference Abstract: 4th Annual Meeting of the International Society of Proton Dynamics in Cancer. doi: 10.3389/conf.fphar.2014.61.00023 Copyright: The abstracts in this collection have not been subject to any Frontiers peer review or checks, and are not endorsed by Frontiers. They are made available through the Frontiers publishing platform as a service to conference organizers and presenters. The copyright in the individual abstracts is owned by the author of each abstract or his/her employer unless otherwise stated. Each abstract, as well as the collection of abstracts, are published under a Creative Commons CC-BY 4.0 (attribution) licence (https://creativecommons.org/licenses/by/4.0/) and may thus be reproduced, translated, adapted and be the subject of derivative works provided the authors and Frontiers are attributed. For Frontiers’ terms and conditions please see https://www.frontiersin.org/legal/terms-and-conditions. Received: 28 Jan 2014; Published Online: 07 Feb 2014. * Correspondence: Prof. Xichun Hu, Fudan University Shanghai Cancer Center, Shanghai, China, xchu2009@hotmail.com Login Required This action requires you to be registered with Frontiers and logged in. To register or login click here. Abstract Info Abstract The Authors in Frontiers Xichun Hu Google Xichun Hu Google Scholar Xichun Hu PubMed Xichun Hu Related Article in Frontiers Google Scholar PubMed Abstract Close Back to top Javascript is disabled. Please enable Javascript in your browser settings in order to see all the content on this page.