Proton pump inhibitors reduce nivolumab efficacy in unresectable advanced or recurrent gastric cancer.

IF 2.7 4区医学 Q3 IMMUNOLOGY

Immunotherapy Pub Date : 2025-04-01 Epub Date: 2025-04-14 DOI:10.1080/1750743X.2025.2491300

Masahito Shibano, Masaya Takahashi, Hitomi Nakatsukasa, Yusuke Ishigami, Takahiro Toyokawa, Koichi Taira, Tomoya Kawaguchi, Yasutaka Nakamura, Hiroyasu Kaneda

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引用次数: 0

Abstract

Background: Proton pump inhibitors (PPI) have been shown to decrease the efficacy of immune checkpoint inhibitors in patients with various cancer types. However, there are few reports on their effect on patients with gastric cancer (GC). Therefore, we investigated the efficacy of nivolumab in patients with GC receiving PPI.

Methods: This retrospective study analyzed data of patients who received nivolumab monotherapy for unresectable advanced or recurrent GC at Osaka Metropolitan University Hospital between September 2017 and December 2021. The primary and secondary endpoints were progression-free survival (PFS) and overall survival (OS), respectively. PPI use was defined as within 30 days before and after initiation of nivolumab monotherapy.

Results: Seventy-seven eligible patients were included in this analysis. PPIs were used in 33 patients, while 36 patients had a previous gastrectomy. Multivariate analysis revealed that only PPI use was an independent predictor of PFS (hazard ratio [HR] 1.93, 95% confidence interval [CI] 1.03-3.64, p = 0.042). Contrastingly, PPI use was not an independent predictor of OS.

Conclusion: PPIs may reduce the efficacy of nivolumab, and their use should be carefully considered in patients receiving nivolumab.

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质子泵抑制剂降低纳武单抗在不可切除的晚期或复发胃癌中的疗效。

背景：质子泵抑制剂（PPI）已被证明可以降低免疫检查点抑制剂在各种癌症类型患者中的疗效。然而，关于其对胃癌（GC）患者影响的报道很少。因此，我们研究了纳武单抗在接受PPI治疗的胃癌患者中的疗效。方法：本回顾性研究分析了2017年9月至2021年12月在大阪都市大学医院接受纳武单抗单药治疗不可切除的晚期或复发性GC患者的数据。主要终点和次要终点分别是无进展生存期（PFS）和总生存期（OS）。PPI的使用定义为在开始纳武单抗单药治疗前后30天内。结果：77例符合条件的患者纳入本分析。33例患者使用了PPIs，而36例患者先前进行过胃切除术。多因素分析显示，只有PPI使用是PFS的独立预测因子（风险比[HR] 1.93, 95%可信区间[CI] 1.03-3.64, p = 0.042）。相反，PPI的使用并不是OS的独立预测因子。结论：PPIs可能会降低纳武单抗的疗效，在接受纳武单抗治疗的患者中使用PPIs应慎重考虑。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Immunotherapy 医学-免疫学

CiteScore

5.00

自引率

3.60%

发文量

113

审稿时长

6-12 weeks

期刊介绍： Many aspects of the immune system and mechanisms of immunomodulatory therapies remain to be elucidated in order to exploit fully the emerging opportunities. Those involved in the research and clinical applications of immunotherapy are challenged by the huge and intricate volumes of knowledge arising from this fast-evolving field. The journal Immunotherapy offers the scientific community an interdisciplinary forum, providing them with information on the most recent advances of various aspects of immunotherapies, in a concise format to aid navigation of this complex field. Immunotherapy delivers essential information in concise, at-a-glance article formats. Key advances in the field are reported and analyzed by international experts, providing an authoritative but accessible forum for this vitally important area of research. Unsolicited article proposals are welcomed and authors are required to comply fully with the journal''s Disclosure & Conflict of Interest Policy as well as major publishing guidelines, including ICMJE and GPP3.