Common over-the-counter medications, including pain relievers and acid reflux treatments, may significantly reduce the effectiveness of cancer immunotherapy, according to a latest commentary published in the Journal of Clinical Oncology. The research highlights a frequently overlooked factor in cancer care: the potential for everyday drugs to interfere with the body’s immune response to treatment.
Researchers at Duke Health reviewed more than 50 studies and found evidence suggesting that widely used drugs like acetaminophen, proton pump inhibitors (PPIs), and corticosteroids can diminish the efficacy of immunotherapy. “We think about drug interactions all the time, but these are interactions with the immune system that we’re not considering,” said Nicholas DeVito, assistant professor in the division of medical oncology at Duke University School of Medicine, and lead author of the commentary. “Adding or subtracting a medication from a patient’s list could mean the difference between cure or not.”
Immunotherapy, which harnesses the body’s own immune system to fight cancer, has become a crucial treatment option for several types of the disease. Unlike traditional chemotherapy, immunotherapy often avoids the harsh side effects associated with killing rapidly dividing cells. However, its success appears to be contingent on factors beyond the immunotherapy drugs themselves.
The Duke Health team’s review indicated that some over-the-counter medications may not only lessen immunotherapy’s effectiveness but also potentially increase the risk or severity of side effects. Conversely, other commonly used drugs, such as antihistamines, statins, and selective serotonin reuptake inhibitors (SSRIs) – a class of antidepressants – may actually enhance the benefits of immunotherapy.
A separate study, highlighted by Nature Medicine, recently investigated the timing of cancer treatment administration, finding potential benefits to delivering treatment in the morning. This research is currently under further investigation, according to reporting from Stat News. While not directly related to over-the-counter medication interactions, it underscores the growing recognition of nuanced factors influencing cancer treatment outcomes.
The commentary’s authors are advocating for improved documentation of all medications – both prescription and over-the-counter – in clinical trials to ensure accurate interpretation of results. They also call for prospective studies specifically designed to confirm how these drugs influence immunotherapy outcomes. “Patients need to be empowered to ask questions about the medications they take, and providers must be more mindful, because even common drugs can change the effectiveness of cancer treatment,” DeVito stated.
To facilitate this, the researchers propose the development of practical tools, such as patient education materials and prompts within electronic health records, to help clinicians incorporate this knowledge into routine care. The Duke Health team’s operate is supported by the Duke Strong Start award, which supports junior physician-scientist faculty at the Duke University School of Medicine.
Recent research published in Nature further supports the idea that concurrent medications can impact immunotherapy effectiveness, specifically in patients receiving immune checkpoint inhibitors. This study examined the impact of concomitant medications on treatment outcomes, adding to the growing body of evidence highlighting the complexity of drug interactions in cancer care.
