SynthesisFrontiers in immunology2023
Do proton pump inhibitors alter the response to immune checkpoint inhibitors in cancer patients? A meta-analysis.
Synthesis in Frontiers in immunology, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 47 papers, 3 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
47 citing papers in PubMed, 3 syntheses or guidelines pooled it, 53 citations in OpenAlex.
- Pooled it
- Acetaminophen use and prognosis in cancer patients treated with immune checkpoint inhibitors: evidence from a meta-analysis.Frontiers in immunology · 2025Pooled it
- Esophagitis and Pneumonitis Related to Concurrent Chemoradiation ± Durvalumab Consolidation in Unresectable Stage III Non-Small-Cell Lung Cancer: Risk Assessment and Management Recommendations Based on a Modified Delphi Process.Current oncology (Toronto, Ont.) · 2024Guideline
- Circulating immune cell profiling in advanced cervical and endometrial cancer patients treated with PD-1 blockade, radiotherapy, and immune modulation in the PRIMMO trial.Frontiers in immunology · 2026Trial
- Tumor microenvironment and gut microbiome in immunotherapy resistance in gastric cancer: clinical questions, biological mechanisms, and evidence-based therapeutic perspectives.Medical oncology (Northwood, London, England) · 2026Review
- Active and Non-Active Comparators Yield Different Estimates of the Association Between Proton Pump Inhibitor Use and Recorded Mortality During Immune Checkpoint Inhibitor Therapy for Advanced Non-Small Cell Lung Cancer.Pharmacoepidemiology and drug safety · 2026Article
- Impact of Concomitant Proton Pump Inhibitor Use on Oncologic Outcomes of Neoadjuvant Chemoimmunotherapy in Locally Advanced Gastric Cancer: A Multicenter Real-World Study.Annals of surgical oncology · 2026Article
- Association of probiotic use with nivolumab efficacy in gastric cancer patients on gastric acid suppressants.iScience · 2026Article
- Article
- Concomitant medication reporting should accompany fecal microbiota transplantation plus anti-PD-1 therapy in gastric cancer.Journal for immunotherapy of cancer · 2026Article
- Microbiota and immune-related adverse events in cancer immunotherapy.Nature reviews. Cancer · 2026Review
- Association of proton pump inhibitor use with clinical outcomes in patients with advanced non-small cell lung cancer receiving immune checkpoint inhibitors.Journal of thoracic disease · 2026Article
- How should we interpret the use of vonoprazan and proton pump inhibitors during immunotherapy for hepatocellular carcinoma?International journal of clinical oncology · 2026Article
- Immunological Drug-Drug Interactions in Immune Checkpoint Inhibitor Therapy: Mechanisms, Clinical Evidence, and Artificial Intelligence.Current oncology reports · 2026Review
- Gut microbiotas attributed to disorders and diseases of the gastrointestinal tract, colorectal cancer, bladder cancer: Geographical factors, inflammation, metabolic toxic.World journal of gastrointestinal pharmacology and therapeutics · 2026Article
- Decoding Microbiota in Genitourinary Oncology: Biological Mechanisms and Clinical Implications-A Narrative Review.Cancers · 2026Review
- Gut dysbiosis in oncology: a risk factor for immunoresistance.Cell research · 2026Review
- Bacteria-related signals in brain metastases: evidence boundaries, tumor-microenvironment remodeling, and translational prospects.Frontiers in cell and developmental biology · 2026Review
- Non-nutritive sweeteners, the gut microbiome, and tumor immunity: evidence hierarchy and a sucralose-centered translational model.Frontiers in nutrition · 2026Review
- 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
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
7 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Introduction: Gut microbiota can significantly affect the effectiveness of immune checkpoint inhibitors (ICIs) in cancer patients. Recently, antibiotics were shown to decrease survival rate of patients treated by ICIs. Proton pump inhibitors (PPIs) can indeed modulate microbiota's diversity, therefore altering ICIs response. A meta-analysis was performed based on published data to verify this hypothesis. Methods: In this study, over 41 publications, exploring the impact of concomitant PPI treatment on outcomes of ICI-treated patients, were analyzed. Evaluated endpoints were overall survival (OS) and progression-free survival (PFS). Pooled hazard ratios (HRs) with a 95% confidence interval (CI) were reported in ICIs in PPI users versus non-PPI users. Subgroup analyses were performed to minimize the impact of study heterogeneity and to investigate the influence of PPI on the different groups of interest. There was no evidence of publication bias for OS and PFS analysis in subgroup analysis. Results: Forty-one studies were included in the meta-analysis, including a total of 20,042 patients. OS of patients receiving ICIs was negatively correlated in patients concomitantly treated with PPI (HR=1.37; 95%CI, 1.23-1.52). PFS of cancer patients receiving ICIs was also negatively correlated with PPI treatment (HR=1.28; 95%CI, 1.15-1.42). PPI and ICI use was associated with worst OS and PFS not only for non-small-cell lung cancer (NSCLC) or urothelial cancer patients but also for patients treated with anti PD-1 (OS) and anti PD-L1 (OS and PFS) immunotherapies when administered in non-first line and when PPI was received as baseline treatment or in 60 days before ICI initiation. PPI and ICI use also showed the worst OS and PFS for patients from Europe and Asia. Conclusion: This meta-analysis suggests that PPI treatment leads to significantly worse outcomes in advanced cancer patients treated by ICIs in terms of PFS and OS.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.