Evidence map›Paper›PMID 40504459›Full record

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.

Masaya Takahashi, Hitomi Nakatsukasa, Masahito Shibano, Yusuke Ishigami, Takako Oka, Yoko Tani, Tomoya Kawaguchi, Yasutaka Nakamura, Hiroyasu Kaneda

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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.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from 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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed.

  1. Observational
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors.

Masaya TakahashiDepartment of Pharmacy, Osaka Metropolitan University Hospital, Osaka, Japan.
Hitomi NakatsukasaDepartment of Pharmacy, Osaka Metropolitan University Hospital, Osaka, Japan.
Masahito ShibanoDepartment of Pharmacy, Osaka Metropolitan University Hospital, Osaka, Japan.
Yusuke IshigamiDepartment of Pharmacy, Osaka Metropolitan University Hospital, Osaka, Japan.
Takako OkaDepartment of Clinical Oncology, Graduate School of Medicine, Osaka Metropolitan University, 1-4-3 Asahi-Machi, Abeno-Ku, Osaka, 545-8585, Japan.
Yoko TaniDepartment of Clinical Oncology, Graduate School of Medicine, Osaka Metropolitan University, 1-4-3 Asahi-Machi, Abeno-Ku, Osaka, 545-8585, Japan.
Tomoya KawaguchiDepartment of Clinical Oncology, Graduate School of Medicine, Osaka Metropolitan University, 1-4-3 Asahi-Machi, Abeno-Ku, Osaka, 545-8585, Japan.
Yasutaka NakamuraDepartment of Pharmacy, Osaka Metropolitan University Hospital, Osaka, Japan.
Hiroyasu KanedaDepartment of Clinical Oncology, Graduate School of Medicine, Osaka Metropolitan University, 1-4-3 Asahi-Machi, Abeno-Ku, Osaka, 545-8585, Japan. kaneda.hiroyasu@omu.ac.jp.ORCID http://orcid.org/0000-0002-7696-2391

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

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.

Indexed as

Carcinoma, Non-Small-Cell LungImmune Checkpoint InhibitorsLung NeoplasmsProton Pump InhibitorsPyrrolesSulfonamidesAdultAgedAged, 80 and overFemaleHumansMaleMiddle AgedProgression-Free SurvivalRetrospective StudiesTreatment Outcome1-(5-(2-fluorophenyl)-1-(pyridin-3-ylsulfonyl)-1H-pyrrol-3-yl)-N-methylmethanamineImmune Checkpoint InhibitorsProton Pump InhibitorsPyrrolesSulfonamidesImmune checkpoint inhibitorLung cancerProton pump inhibitorVonoprazan

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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.