Proton Pump Inhibitors in cancer patients: How useful they are? A review of the most common indications for their use

Abstract

Proton-Pump Inhibitors (PPIs) are commonly prescribed in the general population and in cancer patients. A supposed role in the prevention of gastric mucosal damage apparently justify their use in patients undergoing cytotoxic chemotherapy, steroids and radiotherapy on the gastro-duodenal region. They are frequently given also to patients admitted to Intensive Care Units, for the prevention of stress-related gastric ulcers. The evidence about these use of gastroprotection is reviewed. In the majority of the cases the prescription of PPIs is not justified. In two circumstances (chemotherapy and stress-related gastric disease) randomized studies have shown a protective action of PPIs although this effect did not translate into the reduction of serious clinical consequences. PPIs are not free of toxic effects that are acknowledged by an expanding literature. Also the interaction with anticancer drugs is a potential source of unwanted consequences.

Keywords: Cancer; Chemotherapy; Drug interactions; Proton-Pump Inhibitors; Steroids.