{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T15:49:22Z","timestamp":1791992962115,"version":"4.4.0"},"reference-count":33,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2019,1,3]],"date-time":"2019-01-03T00:00:00Z","timestamp":1546473600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["acsjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cancer"],"published-print":{"date-parts":[[2019,4]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>The concomitant use of tyrosine kinase inhibitors (TKIs) and proton pump inhibitors (PPIs) is a significant concern because of potential drug\u2010drug interaction that reduces TKI absorption, thus potentially reducing the effectiveness of TKIs. The objective of this study was to evaluate the prevalence and predictors of concomitant TKI\u2010PPI receipt and its impact on survival and therapy discontinuation in older adults with cancer.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This retrospective study used linked Surveillance, Epidemiology, and End Results\u2010Medicare data for the years 2007 through 2012. In total, 12,538 patients with lung cancer, renal cell cancer, chronic myelogenous leukemia, liver cancer, or pancreatic cancer were included. The primary exposure variable was concomitant receipt of TKI\u2010PPI, defined as at least 30 days of PPI use in the first 90 days from the start of the TKI (exposure period). The outcomes measured were overall survival and discontinuation of therapy in 90 days and 1 year after the end of the exposure period. Cox proportional\u2010hazards regression with inverse probability of treatment weighting was used to evaluate the association between exposure and outcome.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The overall prevalence of TKI\u2010PPI receipt was 22.7%. Predictors that were associated with increased use included polypharmacy and prior PPI receipt. TKI\u2010PPI use decreased survival in 90 days (hazard ratio, 1.16; 95% confidence interval, 1.05\u20101.28) and in 1 year (hazard ratio, 1.10; 95% confidence interval, 1.04\u20101.18) but was not associated with discontinuation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Nearly 1 in 4 older adults with cancer who receive TKIs also receive PPIs concomitantly, and concomitant use is associated with an increased risk of death. Concerted efforts to manage medications are needed to identify and reduce the receipt of PPIs when TKIs are initiated.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/cncr.31917","type":"journal-article","created":{"date-parts":[[2019,1,3]],"date-time":"2019-01-03T11:33:10Z","timestamp":1546515190000},"page":"1155-1162","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":96,"title":["The concomitant use of tyrosine kinase inhibitors and proton pump inhibitors: Prevalence, predictors, and impact on survival and discontinuation of therapy in older adults with cancer"],"prefix":"10.1002","volume":"125","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4221-7801","authenticated-orcid":false,"given":"Manvi","family":"Sharma","sequence":"first","affiliation":[{"name":"Department of Pharmacy Administration The University of Mississippi Oxford Mississippi"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Holly M.","family":"Holmes","sequence":"additional","affiliation":[{"name":"Division of Geriatric and Palliative Medicine, McGovern Medical School The University of Texas Health Science Center Houston Texas"},{"name":"Department of Pharmaceutical Health Outcomes and Policy University of Houston Houston Texas"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hemalkumar B.","family":"Mehta","sequence":"additional","affiliation":[{"name":"Department of Pharmaceutical Health Outcomes and Policy University of Houston Houston Texas"},{"name":"Department of Surgery The University of Texas Medical Branch Galveston Texas"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hua","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Pharmaceutical Health Outcomes and Policy University of Houston Houston Texas"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rajender R.","family":"Aparasu","sequence":"additional","affiliation":[{"name":"Department of Pharmaceutical Health Outcomes and Policy University of Houston Houston Texas"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ya\u2010Chen T.","family":"Shih","sequence":"additional","affiliation":[{"name":"Department of Health Services Research The University of Texas MD Anderson Cancer Center Houston Texas"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sharon H.","family":"Giordano","sequence":"additional","affiliation":[{"name":"Department of Health Services Research The University of Texas MD Anderson Cancer Center Houston Texas"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael L.","family":"Johnson","sequence":"additional","affiliation":[{"name":"Department of Pharmaceutical Health Outcomes and Policy University of Houston Houston Texas"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2019,1,3]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.2146\/ajhp070036"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.39069.489757.55"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.6004\/jnccn.2008.2003"},{"key":"e_1_2_9_5_1","unstructured":"OncologyPRO European Society for Medical Oncology.Drug\u2010Drug Interactions Associated with Kinase Inhibitors\u2014Pharmacokinetics Absorption. 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