The absorption of pazopanib depends on gastric pH. PPIs are frequently prescribed for cancer patients to modify gastric acidity, decreasing pazopanib absorption. The aim of our study was, retrospectively, to investigate the impact of PPIs on the clinical efficacy and safety of pazopanib in a cohort of patients treated in our health center. Of the 147 patients who were included retrospectively, 79 (54%) did not take PPIs concomitantly with pazopanib (cohort 1), while 68 (46%) patients did take PPIs concomitantly with pazopanib (cohort 2). The efficacy parameters were lower in patients taking pazopanib and PPIs: the i/tumor response was statistically different between the two cohorts (p = 0.008), in particular, with 19% vs. 3% of the objective response and 24% vs. 43% of progression in cohorts 1 and 2, respectively; ii/median overall survival was 17.6 (95% CI: 12.5–32.8) months in cohort 1 and 8.6 months (95% CI: 5.9–18.6) in cohort 2 (HR = 1.7 [95% CI: 1.2–2.5]; p < 0.006); on multivariable analysis, overall survival was associated with performance status, PPI intake, tumor location, hemoglobin, and PMN/lymphocyte ratio. In contrast, the dose reduction for toxicity and severe adverse events were (non-significantly) less frequent in cohort 1. To conclude, our study shows that combining PPIs with pazopanib has an adverse effect on overall survival. The clinical modifications that were observed are in line with a decrease in pazopanib absorption due to PPIs. This co-medication should be avoided.

Management of prostate cancer (PCa) patients with lung oligometastases remains unclear in the absence of published data. The aim of this study was to evaluate the efficacy of Stereotactic Body Radiotherapy (SBRT) in this setting. We conducted a multicenter retrospective study that included 35 PCa patients treated with SBRT for lung oligometastases in 7 centers across 3 countries. The efficacy was evaluated by the progression free-survival (PFS), defined as pre-SBRT PSA + 25 % or nadir PSA + 25 % and + 2 ng/mL or radiological progression if it occurred before biochemical progression. The local recurrence free-survival (LRFS), distant metastases free-survival (DMFS), Overall Survival (OS) and Androgen Deprivation Therapy free-survival were also assessed. Survival was estimated using the Kaplan Meier method. 35 patients were included with lung oligometastases staged with PET-CT for 97 % and histologically biopsy confirmed for 51 %. 77 % had an oligorecurrent metastatic disease. The median pre SBRT PSA was at 1.7 ng/mL [0.8, 3.0] and the median follow-up after SBRT was 28.7 months. The median PFS was 21.6 months [95 %CI: 21.6; NA] and the median DMFS was 32.4 months [95 %CI: 22.2–NA]. No parameters were significantly associated with PFS on the univariate and multivariate models. For patients who did not start ADT before or concomitantly with SBRT (n = 18), the 1-year ADT free-survival rate was estimated at 87.2 % [71.9;100]. SBRT for PCa lung oligometastases offers good oncological outcomes, comparable to those reported for bone and/or lymph node metastases SBRT. Our results encourage the inclusion of patients with lung oligometastatic disease in clinical trials designed to assess the value of SBRT. SBRT for prostate cancer lung oligometastases shows promising results, similar to treatments for bone or lymph node oligometastases.

Background Immune checkpoint inhibitors (ICI) have changed cancer treatment, but they also bring a risk of immune-mediated cardiac toxicities (IMCT), such as myocarditis. Given the rarity but high mortality rates of IMCT, early detection is crucial. Objectives This study aimed to evaluate the impact of our cardiac monitoring algorithm, based on troponin and electrocardiogram follow up, on patients undergoing ICI therapy, assessing whether it reduces treatment interruptions and severe cardiac adverse events. Methods A retrospective study was conducted using data from the West Cancer Institute in Saint Herblain, France. Patients treated with ICIs for lung cancer or melanoma were divided into two groups: group A treated in 2019 (pre-algorithm) and group B treated in 2020–2021 (post-algorithm). The primary objective was to assess the impact of monitoring on the number of treatment cycles canceled or delayed. The secondary objective was to assess the rate of grade 3–4 cardiac or associated adverse events. Results 162 patients were included (45 – group A, 117 – group B). There was no significant difference in treatment interruptions (26.7% vs. 24.8%, p = 0.96). Moreover, the rate of grade 3–4 cardiac or associated adverse events was similar between the two groups (p = 0.2). Conclusions The implementation of the cardiac monitoring protocol had no negative impact on treatment administration but without reduction of severe cardiac or associated immune induced adverse event. This implementation demonstrated good adherence to the procedure; however, further efforts are needed to optimize strategies for the early detection of rare but serious adverse events.