ArticleJournal of thoracic disease2026
Association of proton pump inhibitor use with clinical outcomes in patients with advanced non-small cell lung cancer receiving immune checkpoint inhibitors.
Article in Journal of thoracic disease, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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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.
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Authors and funding
6 authors.
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Abstract
Background: Immune checkpoint inhibitors (ICIs) have become an important treatment option for patients with advanced non-small cell lung cancer (NSCLC). However, the association between proton pump inhibitor (PPI) use and clinical outcomes remains uncertain, particularly in the setting of short-term peri-treatment exposure. This retrospective study aimed to evaluate the association between PPI use and clinical outcomes in patients with advanced NSCLC receiving ICI therapy. Methods: This single-center retrospective study included 229 patients with advanced NSCLC who received first-line treatment with either ICI monotherapy or ICI combined with chemotherapy between January 1 and December 31, 2023. Follow-up was censored on December 31, 2024. Clinical data were collected, including age, sex, Eastern Cooperative Oncology Group (ECOG) performance status, PD-L1 expression, treatment regimen, and PPI use. Progression-free survival (PFS) and overall survival (OS) were evaluated. Results: Among the 229 patients, 131 (57.2%) received PPI during the peri-treatment period. In patients without PPI use, no significant differences in PFS or OS were observed between ICI monotherapy and ICI combined with chemotherapy. However, among patients with PPI exposure, those treated with ICI plus chemotherapy had significantly longer PFS and OS compared with those receiving ICI monotherapy (both P<0.01). In addition, within the ICI monotherapy subgroup, PPI use was associated with significantly shorter PFS and OS. Inverse probability of treatment weighting (IPTW) analysis demonstrated that this association remained significant after adjustment for baseline confounders. Duration-based analysis further showed that even short-term PPI exposure (≤1 day) was associated with poorer outcomes. Conclusions: PPI use was associated with poorer outcomes in patients with advanced NSCLC, particularly among those receiving ICI monotherapy. This association appeared attenuated in patients treated with ICI combined with chemotherapy, suggesting a treatment-dependent interaction rather than a uniform drug effect.
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