Exploratory evaluation of immunotherapy response and medication use in endometrial and cervical carcinoma

Objective: (s): To assess the effect of medication use during immune checkpoint inhibitor (ICI) therapy on treatment response and oncologic outcomes. Methods: An IRB-approved single-institution retrospective cohort study was performed in patients with endometrial cancer (EC) and cervical cancer (CC)...

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Main Authors: Julia Chalif, Molly Morton, Eric McLaughlin, Anna Gonzalez, Jessica Fulton, Jessica Sciuva, Ioana Marcu, Kristin L. Bixel, David E. Cohn, Casey M. Cosgrove, Larry J. Copeland, Christa I. Nagel, Floor Backes, David M. O’Malley, Daniel J. Spakowicz, Laura M. Chambers
Format: Article
Language:English
Published: Elsevier 2025-08-01
Series:Gynecologic Oncology Reports
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Online Access:http://www.sciencedirect.com/science/article/pii/S2352578925001079
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author Julia Chalif
Molly Morton
Eric McLaughlin
Anna Gonzalez
Jessica Fulton
Jessica Sciuva
Ioana Marcu
Kristin L. Bixel
David E. Cohn
Casey M. Cosgrove
Larry J. Copeland
Christa I. Nagel
Floor Backes
David M. O’Malley
Daniel J. Spakowicz
Laura M. Chambers
author_facet Julia Chalif
Molly Morton
Eric McLaughlin
Anna Gonzalez
Jessica Fulton
Jessica Sciuva
Ioana Marcu
Kristin L. Bixel
David E. Cohn
Casey M. Cosgrove
Larry J. Copeland
Christa I. Nagel
Floor Backes
David M. O’Malley
Daniel J. Spakowicz
Laura M. Chambers
author_sort Julia Chalif
collection DOAJ
description Objective: (s): To assess the effect of medication use during immune checkpoint inhibitor (ICI) therapy on treatment response and oncologic outcomes. Methods: An IRB-approved single-institution retrospective cohort study was performed in patients with endometrial cancer (EC) and cervical cancer (CC) who were treated with ICIs from January 1, 2017 to January 1, 2023. Concomitant medications used during the ICI course were recorded. The associations between medication use and ICI response, progression-free survival (PFS), and overall survival (OS) was assessed. Results: 217 CC and EC patients were treated with ICIs during this study period; 32 % (n = 71) had CC, and 67 % (n = 146) had EC. There was a significant difference in ICI complete response between CC patients who did and did not use oral steroids during treatment. Of CC patients who achieved a complete response, 28 % (n = 7) used steroids vs. 13.6 % (n = 6) of non-steroid users (Fisher’s exact p = 0.045). In patients with EC, proton pump inhibitor (PPI) use was associated with ICI response, with 43.8 % (n = 21) of PPI users achieving a complete response vs. 16.3 % (n = 15) of non-PPI users (chi-squared p = 0.002). PPI use in the EC cohort was associated with improved progression-free survival and overall survival (log-rank p < 0.05). This was also demonstrated among mismatch repair-deficient EC patients where PPI use during ICI therapy significantly associated with both PFS (HR 0.26, 95 % CI 0.12–0.55; p < 0.001) and OS (HR 0.22, 95 % CI 0.08–0.59; p < 0.001).Conclusion(s)In this retrospective cohort study of EC and CC patients treated with ICI therapy, medication use, specifically PPIs and oral steroids, was seen to have a significant positive effect on ICI response, PFS, and OS.
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spelling doaj-art-29017c215a024d92bef6aac3cf9ffb072025-08-21T04:17:02ZengElsevierGynecologic Oncology Reports2352-57892025-08-016010178210.1016/j.gore.2025.101782Exploratory evaluation of immunotherapy response and medication use in endometrial and cervical carcinomaJulia Chalif0Molly Morton1Eric McLaughlin2Anna Gonzalez3Jessica Fulton4Jessica Sciuva5Ioana Marcu6Kristin L. Bixel7David E. Cohn8Casey M. Cosgrove9Larry J. Copeland10Christa I. Nagel11Floor Backes12David M. O’Malley13Daniel J. Spakowicz14Laura M. Chambers15Division of Gynecologic Oncology; The Ohio State University Comprehensive Cancer Center – James Cancer Hospital and Solove Research Institute, Columbus, OH, USADivision of Gynecologic Oncology; The Ohio State University Comprehensive Cancer Center – James Cancer Hospital and Solove Research Institute, Columbus, OH, USAThe Ohio State University School of Biomedical Science, Columbus, OH, USADivision of Gynecologic Oncology; The Ohio State University Comprehensive Cancer Center – James Cancer Hospital and Solove Research Institute, Columbus, OH, USADivision of Gynecologic Oncology; The Ohio State University Comprehensive Cancer Center – James Cancer Hospital and Solove Research Institute, Columbus, OH, USAThe Ohio State University College of Medicine, Columbus, OH, USAThe Ohio State University, Division of Urogynecology, Department of Obstetrics and Gynecology, USADivision of Gynecologic Oncology; The Ohio State University Comprehensive Cancer Center – James Cancer Hospital and Solove Research Institute, Columbus, OH, USADivision of Gynecologic Oncology; The Ohio State University Comprehensive Cancer Center – James Cancer Hospital and Solove Research Institute, Columbus, OH, USADivision of Gynecologic Oncology; The Ohio State University Comprehensive Cancer Center – James Cancer Hospital and Solove Research Institute, Columbus, OH, USADivision of Gynecologic Oncology; The Ohio State University Comprehensive Cancer Center – James Cancer Hospital and Solove Research Institute, Columbus, OH, USADivision of Gynecologic Oncology; The Ohio State University Comprehensive Cancer Center – James Cancer Hospital and Solove Research Institute, Columbus, OH, USADivision of Gynecologic Oncology; The Ohio State University Comprehensive Cancer Center – James Cancer Hospital and Solove Research Institute, Columbus, OH, USADivision of Gynecologic Oncology; The Ohio State University Comprehensive Cancer Center – James Cancer Hospital and Solove Research Institute, Columbus, OH, USADivision of Medical Oncology, Department of Internal Medicine, The Ohio State University Comprehensive Cancer Center, Columbus, OH, USA; Pelotonia Institute for Immuno-Oncology, The Ohio State University Comprehensive Cancer Center, Columbus, OH, USADivision of Gynecologic Oncology; The Ohio State University Comprehensive Cancer Center – James Cancer Hospital and Solove Research Institute, Columbus, OH, USA; Corresponding author at: M-210 Starling Loving Hall 320 W. 10th Avenue Columbus, OH 43210, USA.Objective: (s): To assess the effect of medication use during immune checkpoint inhibitor (ICI) therapy on treatment response and oncologic outcomes. Methods: An IRB-approved single-institution retrospective cohort study was performed in patients with endometrial cancer (EC) and cervical cancer (CC) who were treated with ICIs from January 1, 2017 to January 1, 2023. Concomitant medications used during the ICI course were recorded. The associations between medication use and ICI response, progression-free survival (PFS), and overall survival (OS) was assessed. Results: 217 CC and EC patients were treated with ICIs during this study period; 32 % (n = 71) had CC, and 67 % (n = 146) had EC. There was a significant difference in ICI complete response between CC patients who did and did not use oral steroids during treatment. Of CC patients who achieved a complete response, 28 % (n = 7) used steroids vs. 13.6 % (n = 6) of non-steroid users (Fisher’s exact p = 0.045). In patients with EC, proton pump inhibitor (PPI) use was associated with ICI response, with 43.8 % (n = 21) of PPI users achieving a complete response vs. 16.3 % (n = 15) of non-PPI users (chi-squared p = 0.002). PPI use in the EC cohort was associated with improved progression-free survival and overall survival (log-rank p < 0.05). This was also demonstrated among mismatch repair-deficient EC patients where PPI use during ICI therapy significantly associated with both PFS (HR 0.26, 95 % CI 0.12–0.55; p < 0.001) and OS (HR 0.22, 95 % CI 0.08–0.59; p < 0.001).Conclusion(s)In this retrospective cohort study of EC and CC patients treated with ICI therapy, medication use, specifically PPIs and oral steroids, was seen to have a significant positive effect on ICI response, PFS, and OS.http://www.sciencedirect.com/science/article/pii/S2352578925001079ImmunotherapyEndometrial CancerCervical CancerMedicationsProtein Pump InhibitorsSteroids
spellingShingle Julia Chalif
Molly Morton
Eric McLaughlin
Anna Gonzalez
Jessica Fulton
Jessica Sciuva
Ioana Marcu
Kristin L. Bixel
David E. Cohn
Casey M. Cosgrove
Larry J. Copeland
Christa I. Nagel
Floor Backes
David M. O’Malley
Daniel J. Spakowicz
Laura M. Chambers
Exploratory evaluation of immunotherapy response and medication use in endometrial and cervical carcinoma
Gynecologic Oncology Reports
Immunotherapy
Endometrial Cancer
Cervical Cancer
Medications
Protein Pump Inhibitors
Steroids
title Exploratory evaluation of immunotherapy response and medication use in endometrial and cervical carcinoma
title_full Exploratory evaluation of immunotherapy response and medication use in endometrial and cervical carcinoma
title_fullStr Exploratory evaluation of immunotherapy response and medication use in endometrial and cervical carcinoma
title_full_unstemmed Exploratory evaluation of immunotherapy response and medication use in endometrial and cervical carcinoma
title_short Exploratory evaluation of immunotherapy response and medication use in endometrial and cervical carcinoma
title_sort exploratory evaluation of immunotherapy response and medication use in endometrial and cervical carcinoma
topic Immunotherapy
Endometrial Cancer
Cervical Cancer
Medications
Protein Pump Inhibitors
Steroids
url http://www.sciencedirect.com/science/article/pii/S2352578925001079
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