Differential impact of proton pump inhibitors and antibiotics on immunotherapy efficacy after chemoradiotherapy in locally advanced non-small-cell lung cancer: a post-hoc analysis of the PACIFIC trial.

Baseline use of proton pump inhibitors and antibiotics significantly reduces progression-free and overall survival in unresectable stage III NSCLC patients treated with durvalumab, with hazard ratios up to 1.66.

• Why it matters: Understanding how common medications like proton pump inhibitors and antibiotics impact immunotherapy outcomes is crucial, as gut microbiome disruption may diminish treatment efficacy in early-stage lung cancer.
• What they did: A post-hoc analysis of 660 patients from the PACIFIC trial examined the effects of baseline proton pump inhibitor and antibiotic use on survival outcomes, focusing on those receiving durvalumab versus placebo.
• The result: Proton pump inhibitor use was linked to worse progression-free and overall survival with durvalumab, while antibiotics affected progression-free survival but not overall survival, highlighting potential drug interactions that could influence treatment success.