Histamine and H1 receptors play a crucial role in the tumor microenvironment. Preclinical data showed that concomitant use of antihistamines and immune checkpoint inhibitors (ICIs) might increase the effect of ICIs. This study aimed to evaluate the impact of antihistamines on the oncological outcomes of ICIs. This retrospective study was conducted in a tertiary cancer center. Advanced cancer patients treated with ICIs were included in this study. A total of 133 patients receiving ICIs in the metastatic setting were included. Melanoma (33.1%) was the most common tumor type. The most common ICI was nivolumab (63.2%). Fifty-five (38.4%) patients received antihistamines concomitantly with ICIs. The most common antihistamine was pheniramine (85.5%). The median progression-free survival (PFS) (8.2 vs. 5.1 months, P = 0.016) and overall survival (OS) (16.2 vs. 7.7 months, P = 0.002) were longer in patients receiving antihistamines concomitantly with ICIs. In multivariate analysis, PFS [hazard ratio (HR) = 0.63, 95% CI: 0.40-0.98, P = 0.042] and OS (HR = 0.49, 95% CI: 0.29-0.81, P = 0.006) were also better in those patients after adjusting for confounding factors, such as performance status, bone or liver metastasis, and concurrent chemotherapy. This study suggested that antihistamines may enhance the efficacy of ICIs in patients with advanced cancer. If validated in prospective trials, antihistamines and ICIs combinations might be new options to improve oncological outcomes.

中文翻译：

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抗组胺药的使用对晚期癌症患者免疫检查点抑制剂生存结果的影响。

组胺和 H1 受体在肿瘤微环境中发挥着至关重要的作用。临床前数据表明，同时使用抗组胺药和免疫检查点抑制剂（ICIs）可能会增强 ICI 的效果。本研究旨在评估抗组胺药对 ICI 肿瘤学结果的影响。这项回顾性研究是在三级癌症中心进行的。本研究纳入了接受 ICI 治疗的晚期癌症患者。总共包括 133 名在转移环境中接受 ICI 的患者。黑色素瘤（33.1%）是最常见的肿瘤类型。最常见的 ICI 是纳武单抗 (nivolumab) (63.2%)。55 名 (38.4%) 患者在 ICI 的同时接受了抗组胺药治疗。最常见的抗组胺药是苯那敏（85.5%）。在接受 ICI 联合治疗的患者中，中位无进展生存期 (PFS)（8.2 个月与 5.1 个月，P = 0.016）和总生存期（OS）（16.2 个月与 7.7 个月，P = 0.002）更长。在多变量分析中，这些患者的 PFS [风险比 (HR) = 0.63，95% CI：0.40-0.98，P = 0.042] 和 OS（HR = 0.49，95% CI：0.29-0.81，P = 0.006）也更好调整混杂因素（例如体能状态、骨或肝转移以及同步化疗）后的患者。这项研究表明，抗组胺药可能会增强 ICI 对晚期癌症患者的疗效。如果在前瞻性试验中得到验证，抗组胺药和 ICI 组合可能是改善肿瘤结果的新选择。