Modulating Treatment Outcomes of Patients with Solid Tumors in Immunotherapy Trials: A Drug Interaction Analysis from a Phase 1 Unit

Authors

Camila Braganca Xavier
Clark R Andersen
JoAnn Lim
Julian H Slade
Stacie A Bean
Lei Kang
Hung Le
Apostolia M Tsimberidou
Aung Naing
David S Hong
Ecaterina E Dumbrava
Jordi Rodon Ahnert
Paula R Pohlmann
Sarina A Piha-Paul
Stephane Champiat
Timothy A Yap
Tin-Yun Tang
Funda Meric-Bernstam
Siqing Fu

Publication Date

8-27-2025

Journal

Cancer Research Communications

DOI

10.1158/2767-9764.CRC-25-0033

PMID

40862547

Abstract

Concurrent use of medications can modulate the effectiveness of immunotherapy. Although this interaction is well documented for immune checkpoint inhibitors, whether this occurs with new experimental compounds has not been evaluated. A computerized data extraction tool was used to collect clinical data and identify the prescription of a predefined set of medications within 30 days of immunotherapy infusion in the Department of Investigational Cancer Therapeutics at The University of Texas MD Anderson Cancer Center. The primary endpoints were median overall survival (OS) and progression-free survival. Tumor responses were addressed using RECIST. We identified 897 patients. The most prevalent tumor types were colorectal (24.5%), head and neck (10.5%), and pancreatic (9.4%). The immunotherapy administered consisted of monoclonal antibodies and fusion proteins (64.7%), immune modulators (IMs; 20.8%), combinations of IMs and antibodies (9.2%), and oncolytic viruses and cancer vaccines (5.3%). The most frequently prescribed drugs were narcotics (70.5%), antiemetics (49.1%), antihistamines (34.6%), antibiotics (31.2%), and proton pump inhibitors (PPIs; 28.7%). Patients receiving antihistamines exhibited increased rates of stable disease and partial response (chi-squared = 8.48; P = 0.014) on the IMs and antibodies combination. The benefit of antihistamines was confirmed in a multivariate analysis of OS (HR, 0.752 [95% CI, 0.603-0.938]; P = 0.012). For patients with colorectal cancer, PPI use was associated with shortened survival, with a median OS of 5.2 months with PPI use and 8.6 months without it (P < 0.001). Our findings highlight the need for strategies to guide concurrent medication choices for patients receiving immunotherapy in early-phase trials.

Published Open-Access

yes

Recommended Citation

Braganca Xavier, Camila; Andersen, Clark R; Lim, JoAnn; et al., "Modulating Treatment Outcomes of Patients with Solid Tumors in Immunotherapy Trials: A Drug Interaction Analysis from a Phase 1 Unit" (2025). Faculty, Staff and Student Publications. 4818.
https://digitalcommons.library.tmc.edu/uthgsbs_docs/4818