title: High-doses of proton pump inhibitors in refractory gastro-intestinal cancer: A case series and the state of art.
abstract: BACKGROUND
  In recent years, proton pump inhibitors (PPIs) have been investigated at high-dose to modulate tumour microenvironment acidification thus restoring chemotherapeutic sensitivity. Moreover, several clinical data supports the role of cytotoxic drugs at low-dose continuously delivered as anticancer therapy.
  
  
  METHODS
  Clinical records of three patients affected with gastrointestinal cancer refractory to standard treatments, who had received a combination of high-dose rabeprazole and metronomic chemotherapy were reviewed.
  
  
  RESULTS
  The first case, a 78-year-old man was treated for lung metastasis from colon adenocarcinoma. The second case, a 73-year-old man was treated for metastatic rectal cancer to the liver. The third one, a 68-year-old man, underwent the combination regimen for colon cancer with lung, liver and peritoneal metastases.
  
  
  CONCLUSIONS
  Despite the failure of previous standard chemotherapy for metastatic disease, good clinical outcome was shown in these patients treated with an unconventional association of high-dose PPIs and metronomic chemotherapy.
authors.affiliation: Department of Molecular and Clinical Medicine, "Sapienza" University of Rome, Italy. Electronic address: rsfalcone@libero.it.
authors.forename: Rosa
authors.initials: R
authors.lastname: Falcone
authors.affiliation: Department of Molecular and Clinical Medicine, "Sapienza" University of Rome, Italy.
authors.forename: Michela
authors.initials: M
authors.lastname: Roberto
authors.affiliation: Department of Molecular and Clinical Medicine, "Sapienza" University of Rome, Italy.
authors.forename: Chiara
authors.initials: C
authors.lastname: D'Antonio
authors.affiliation: Department of Molecular and Clinical Medicine, "Sapienza" University of Rome, Italy.
authors.forename: Adriana
authors.initials: A
authors.lastname: Romiti
authors.affiliation: Department of Molecular and Clinical Medicine, "Sapienza" University of Rome, Italy.
authors.forename: Annalisa
authors.initials: A
authors.lastname: Milano
authors.affiliation: Department of Molecular and Clinical Medicine, "Sapienza" University of Rome, Italy.
authors.forename: Concetta Elisa
authors.initials: CE
authors.lastname: Onesti
authors.affiliation: Department of Molecular and Clinical Medicine, "Sapienza" University of Rome, Italy.
authors.forename: Paolo
authors.initials: P
authors.lastname: Marchetti
authors.affiliation: National Institute of Health, Rome, Italy.
authors.forename: Stefano
authors.initials: S
authors.lastname: Fais
mesh_terms: D000230:Adenocarcinoma / Q000188:drug therapy*; D000368:Aged; D000970:Antineoplastic Agents / Q000008:administration & dosage*; D015179:Colorectal Neoplasms / Q000188:drug therapy*; D006801:Humans; D008297:Male; D009362:Neoplasm Metastasis; D054328:Proton Pump Inhibitors / Q000008:administration & dosage*; D064750:Rabeprazole / Q000008:administration & dosage*; D016896:Treatment Outcome
chemical_list: D000970:Antineoplastic Agents; D054328:Proton Pump Inhibitors; D064750:Rabeprazole
keywords: Colorectal cancer; Metronomic chemotherapy; Proton-pump inhibitors; Refractory disease