Over-the-Counter Medications May Alter Cancer Immunotherapy Outcomes
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DURHAM, N.C. – Immunotherapy is offering new hope for cancers that once had grim prognoses by harnessing the body’s own immune system to fight the disease, often sparing patients from the harsh side effects of chemotherapy. But its success may hinge on everyday medications people are taking during treatment.
That often-overlooked factor in cancer care is highlighted in a new commentary from Duke Health researchers, published in the Journal of Clinical Oncology.
“We think about drug interactions all the time, but these are interactions with the immune system that we’re not considering,” said lead author Nicholas DeVito, M.D., assistant professor in the division of medical oncology in the Department of Medicine at Duke University School of Medicine. “Adding or subtracting a medication from a patient’s list could mean the difference between cure or not.”
The Duke team reviewed more than 50 studies and found many over-the-counter medications commonly used by patients to reduce pain, inflammation, and side effects during cancer treatment may change how their bodies respond to immunotherapy.
The researchers found evidence that widely used drugs such as acetaminophen, proton pump inhibitors, and corticosteroids can reduce the efficacy of immunotherapy treatment.
“Some of these drugs might not only make immunotherapy less effective, but they could also be causing side effects or increasing the rate of side effects,” said DeVito.
On the other hand, drugs like antihistamines, statins, and certain anti-depressants known as selective serotonin reuptake inhibitors (SSRIs) may enhance the effectiveness of immunotherapy.
The commentary’s authors recommend better documentation of both prescription and over-the-counter medications in clinical trials to ensure accurate interpretation of results. They also call for prospective studies to confirm how these drugs influence immunotherapy outcomes.
The team advocates for practical tools, such as patient education materials and electronic health record prompts, that make it easier for clinicians to incorporate this knowledge into everyday care.
“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,” said DeVito.
In addition to DeVito, commentary authors include Erica Gray, Daniel Schrum, and Scott Antonia.
DeVito’s work is supported by the Duke Strong Start award which is designed to support junior physician-scientist faculty in the Duke University School of Medicine.