@article{MAFFEZZOLI2025, 
author = {MICHELE MAFFEZZOLI and GIULIA CLAIRE GIUDICE and GIACOMO IOVANE and MARTINA MANINI and ELENA RAPACCHI and GIUSEPPE CARUSO and NICOLA SIMONI and STEFANIA FERRETTI and STEFANO PULIATTI and DAVIDE CAMPOBASSO and SEBASTIANO BUTI},
title = {The effect of concomitant drugs on oncological outcomes in patients treated with immunotherapy for metastatic urothelial carcinoma: a narrative review},
year = {2025},
journal = {Oncology Research},
volume = {33},
number = {4},
pages = {741-757},
keywords = {Immune checkpoint inhibitors (ICIs), Urothelial carcinoma (UC), Concomitant drugs, Proton pump inhibitors, Antibiotics (Abs), Angiotensin-converting enzyme inhibitors (ACEIs)},
url = {https://www.sciopen.com/article/10.32604/or.2024.057278},
doi = {10.32604/or.2024.057278},
abstract = {Backgroundimmune checkpoint inhibitors (ICIs) have revolutionized the treatment of metastatic urothelial carcinoma (mUC), significantly improving survival outcomes. However, a subset of patients do not respond to ICIs, prompting research into potential predictive factors. Commonly prescribed medications such as corticosteroids, proton-pump inhibitors (PPIs), antibiotics (Abs), antihypertensives, and analgesics may influence ICI effectiveness. Methodswe conducted a literature search on PubMed to investigate the impact of concomitant medications on the outcomes of patients with mUC, treated with ICIs. We selected the most relevant studies and performed a narrative review. Resultscorticosteroids, PPIs and Abs have been associated with reduced survival in ICI-treated patients, including those with mUC. In contrast, antihypertensive agents like renin-angiotensin system inhibitors and beta-blockers may enhance ICI efficacy, though evidence remains inconclusive. The impact of other medications, such as statins, metformin, and analgesics, on ICI outcomes is less clear, with some data suggesting a detrimental impact on immune response.Conclusionsthis narrative review synthesizes current evidence on how concomitant medications affect outcomes in mUC patients treated with ICIs.}
}