ArticleInternational journal of clinical oncology2025
Potassium-competitive acid blocker has more negative impacts on clinical outcomes in patients with non-small cell lung cancer treated with checkpoint inhibitors than those of proton pump inhibitors.
Article in International journal of clinical oncology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.
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Who cites it
4 citing papers in PubMed.
- Association of Probiotics with Effectiveness of Nivolumab or Pembrolizumab in Patients with Esophageal Cancer Taking Proton Pump Inhibitors: A Multicenter Retrospective Study.Journal of gastrointestinal cancer · 2026Observational
- Effect of Vonoprazan, potassium-competitive acid blocker, on Atezolizumab plus Bevacizumab efficacy in patients with hepatocellular carcinoma: a multicenter retrospective study.International journal of clinical oncology · 2026Article
- Immune checkpoint inhibitor resistance in non-small cell lung cancer: limits of vascular endothelial growth factor inhibition and new directions.Journal of thoracic disease · 2025Article
- Proton Pump Inhibitors Attenuate the Effectiveness of Nivolumab Monotherapy in Patients with Advanced Gastric Cancer: A Retrospective Study.Journal of gastrointestinal cancer · 2025Observational
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Authors and funding
9 authors.
Funding
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Abstract
backgroundProton pump inhibitors (PPIs) are well-known inducers of gut dysbiosis because oral bacteria cannot be sterilized owing to their gastric acid-suppressing effect. PPI-induced gut dysbiosis is associated with shorter progression-free survival (PFS) and overall survival (OS) in patients with non-small cell lung cancer (NSCLC) treated with immune checkpoint inhibitors (ICIs). Although vonoprazan exhibits more powerful acid suppression than PPIs, its effect on ICI therapy outcomes remains unknown. We evaluated vonoprazan on ICI therapy efficacy in patients with NSCLC.
methodsThis retrospective study included patients aged ≥ 18 years with advanced or recurrent NSCLC receiving ICI monotherapy or ICI plus chemotherapy between January 2016 and December 2021 at Osaka Metropolitan University Hospital.
resultsOf the 289 patients, 121 received PPIs, 22 received vonoprazan, and 146 did not receive either vonoprazan or PPIs (control group). In multivariate analysis, the PFS in the PPI (hazard ratio [HR], 1.63; 95% confidence interval [CI], 1.21-2.21; p = 0.0014) and vonoprazan groups (HR, 2.49; 95% CI, 1.47-4.23; p < 0.001) were significantly shorter than those in the control group. The OS in the PPI (HR, 1.74; 95% CI, 1.23-2.45; p = 0.0017) and vonoprazan groups (HR, 5.24; 95% CI, 2.88-9.53; p < 0.001) were also significantly shorter than those in the control group.
conclusionVonoprazan was associated with worse PFS and OS in patients with NSCLC treated with ICIs than those who did not receive PPIs or vonoprazan. Moreover, vonoprazan may have a more negative impact on ICI therapy efficacy than PPI.
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