Do commonly prescribed medications for pain and stomach acid control interfere with immune therapy medications in cancer?

Commonly prescribed medications used in cancer care management for pain control (i.e. opiates) and for stomach acid control (i.e. PPIs or proton pump inhibitors) are becoming increasingly linked with worse outcomes in those who receive immunotherapy cancer drug treatment known as check point inhibitors (i.e. Keytruda, Optivo, etc.). While the data is preliminary and retrospective, in clinical practice this area receives little to no attention. You do not hear recommendations for perhaps trying other methods or other medications such as even NSAIDs for pain control or the suggestion of the more older anti-acids that may be more benign in nature (i.e. H2 blockers, etc.). It is uncertain if perhaps patients who require such medications may be sicker and hence their immune response more compromised or hindered. However, the negative data signal continues to be raised by the growing research. It may be time to have more honest discussions between patients and healthcare providers in such areas as these immune therapy medications are costly and patients deserve optimal responses whenever possible when they are used. Perhaps for some attempting a more lower, but yet effective dose first, when using opiates and PPIs should be considered when needed. #cancer #ICI #opiates #PPIs

Association of opioid use with survival in patients with cancer treated with immune checkpoint inhibitors: it is time for evidence-based behaviors

Effect of Antacids on the Survival of Patients With Metastatic Urothelial Carcinoma Treated With Pembrolizumab