Shibano Masahito, Takahashi Masaya, Nakatsukasa Hitomi, Ishigami Yusuke, Toyokawa Takahiro, Taira Koichi, Kawaguchi Tomoya, Nakamura Yasutaka, Kaneda Hiroyasu
Department of Pharmacy, Osaka Metropolitan University Hospital, Osaka, Japan.
Department of Quality and Safety Management, Osaka Metropolitan University Hospital, Osaka, Japan.
Immunotherapy. 2025 Apr;17(5):331-338. doi: 10.1080/1750743X.2025.2491300. Epub 2025 Apr 14.
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.
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.
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, = 0.042). Contrastingly, PPI use was not an independent predictor of OS.
PPIs may reduce the efficacy of nivolumab, and their use should be carefully considered in patients receiving nivolumab.
质子泵抑制剂（PPI）已被证明会降低免疫检查点抑制剂对各种癌症类型患者的疗效。然而，关于其对胃癌（GC）患者影响的报道较少。因此，我们研究了纳武利尤单抗对接受PPI治疗的GC患者的疗效。
这项回顾性研究分析了2017年9月至2021年12月期间在大阪市立大学医院接受纳武利尤单抗单药治疗不可切除的晚期或复发性GC患者的数据。主要和次要终点分别为无进展生存期（PFS）和总生存期（OS）。PPI的使用定义为纳武利尤单抗单药治疗开始前和后的30天内。
77例符合条件的患者纳入本分析。33例患者使用了PPI，36例患者曾接受过胃切除术。多因素分析显示，只有PPI的使用是PFS的独立预测因素（风险比[HR]1.93，95%置信区间[CI]1.03 - 3.64，P = 0.042）。相反，PPI的使用不是OS的独立预测因素。
PPI可能会降低纳武利尤单抗的疗效，在接受纳武利尤单抗治疗的患者中应谨慎考虑使用PPI。
