{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,26]],"date-time":"2026-10-26T15:46:37Z","timestamp":1793029597542,"version":"4.5.0"},"reference-count":24,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,9,21]],"date-time":"2026-09-21T00:00:00Z","timestamp":1789948800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2026,9,21]],"date-time":"2026-09-21T00:00:00Z","timestamp":1789948800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Intl Journal of Cancer"],"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>\n                    Proton pump inhibitors (PPIs) are commonly prescribed in patients with cancer. Prior studies suggest concomitant PPI use may reduce the efficacy of oral capecitabine through impaired absorption, with no interaction expected with intravenous 5\u2010fluorouracil (5\u2010FU). Using the Australian Comprehensive Cancer Outcomes and Research Database (ACCORD), we identified patients with Stage III colon cancer diagnosed between 1 January 2006 and 31 December 2023. Concomitant PPI use during adjuvant chemotherapy was determined by chart review. We evaluated the prevalence of PPI use with fluoropyrimidine\u2010containing adjuvant therapy and its association with recurrence\u2010free survival (RFS) and overall survival (OS). A total of 459 patients were included as follows: 63 (14%) received 5\u2010FU alone, 115 (25%) capecitabine alone, 148 (32%) FOLFOX and 133 (29%) CAPOX. High\u2010risk disease (T4 and\/or N2) was present in 203 patients (44%). Overall, 142 patients (31%) received a PPI during adjuvant chemotherapy, with similar rates across treatment groups (\n                    <jats:italic>p<\/jats:italic>\n                    \u2009=\u20090.952). Formal interaction testing did not demonstrate significant heterogeneity of PPI effect across treatment regimens (RFS: LR test\n                    <jats:italic>p<\/jats:italic>\n                    \u2009=\u20090.615; OS: LR test\n                    <jats:italic>p<\/jats:italic>\n                    \u2009=\u20090.143). However, in high\u2010risk patients receiving CAPOX, PPI use was associated with reduced RFS (HR 3.07, 95% CI 1.38\u20136.84,\n                    <jats:italic>p<\/jats:italic>\n                    \u2009=\u20090.006) and OS (HR 4.11, 95% CI 1.44\u201311.74,\n                    <jats:italic>p<\/jats:italic>\n                    \u2009=\u20090.008). No impact was observed with capecitabine monotherapy, 5\u2010FU, or FOLFOX. Concomitant PPI use is common in Australian patients with Stage III colon cancer. While formal interaction testing did not reach statistical significance, PPI use was associated with inferior survival outcomes in high\u2010risk patients receiving CAPOX.\n                  <\/jats:p>","DOI":"10.1002\/ijc.70754","type":"journal-article","created":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T04:20:33Z","timestamp":1790050833000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Concomitant Use of Proton Pump Inhibitors and Survival Outcomes in Patients Receiving Adjuvant Chemotherapy for Stage\n                    <scp>III<\/scp>\n                    Colon Cancer"],"prefix":"10.1002","author":[{"given":"Matthew","family":"Loft","sequence":"first","affiliation":[{"name":"Walter and Eliza Hall Institute of Medical Research  Victoria Australia"},{"name":"Western Health  Victoria Australia"},{"name":"Department of Medical Biology University of Melbourne  Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vinoja","family":"Ganeshanathan","sequence":"additional","affiliation":[{"name":"Eastern Health  Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4926-5689","authenticated-orcid":false,"given":"Rachel","family":"Wong","sequence":"additional","affiliation":[{"name":"Eastern Health  Victoria Australia"},{"name":"Monash University Eastern Health Clinical School  Victoria Australia"},{"name":"Epworth Healthcare  Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9175-6329","authenticated-orcid":false,"given":"Shehara","family":"Mendis","sequence":"additional","affiliation":[{"name":"Walter and Eliza Hall Institute of Medical Research  Victoria Australia"},{"name":"Western Health  Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthew","family":"Croxford","sequence":"additional","affiliation":[{"name":"Western Health  Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ian T.","family":"Jones","sequence":"additional","affiliation":[{"name":"Royal Melbourne Hospital  Victoria Australia"},{"name":"Department of Surgery University of Melbourne  Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Grace","family":"Gard","sequence":"additional","affiliation":[{"name":"Walter and Eliza Hall Institute of Medical Research  Victoria Australia"},{"name":"Western Health  Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sue\u2010Anne","family":"McLachlan","sequence":"additional","affiliation":[{"name":"Department of Medical Biology University of Melbourne  Australia"},{"name":"St Vincent's Health  Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeanne","family":"Tie","sequence":"additional","affiliation":[{"name":"Walter and Eliza Hall Institute of Medical Research  Victoria Australia"},{"name":"Department of Medical Biology University of Melbourne  Australia"},{"name":"Peter MacCallum Cancer Centre  Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lucy","family":"Gately","sequence":"additional","affiliation":[{"name":"Walter and Eliza Hall Institute of Medical Research  Victoria Australia"},{"name":"Department of Medical Biology University of Melbourne  Australia"},{"name":"Alfred Health  Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter","family":"Gibbs","sequence":"additional","affiliation":[{"name":"Walter and Eliza Hall Institute of Medical Research  Victoria Australia"},{"name":"Western Health  Victoria Australia"},{"name":"Department of Medical Biology University of Melbourne  Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,9,21]]},"reference":[{"key":"e_1_2_13_2_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2021.13739"},{"key":"e_1_2_13_3_1","doi-asserted-by":"publisher","DOI":"10.1021\/mp400403s"},{"key":"e_1_2_13_4_1","doi-asserted-by":"publisher","DOI":"10.4066\/AMJ.2014.2093"},{"key":"e_1_2_13_5_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199002083220602"},{"key":"e_1_2_13_6_1","doi-asserted-by":"publisher","DOI":"10.2165\/00003088\u2010200140020\u201000002"},{"key":"e_1_2_13_7_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2015.63.4238"},{"key":"e_1_2_13_8_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2006.08.2974"},{"key":"e_1_2_13_9_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2015.60.9107"},{"key":"e_1_2_13_10_1","doi-asserted-by":"publisher","DOI":"10.1093\/annonc\/mdr366"},{"key":"e_1_2_13_11_1","doi-asserted-by":"publisher","DOI":"10.1177\/1758835918818347"},{"key":"e_1_2_13_12_1","doi-asserted-by":"publisher","DOI":"10.1007\/s12094\u2010019\u201002254\u20100"},{"key":"e_1_2_13_13_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamaoncol.2016.3358"},{"key":"e_1_2_13_14_1","doi-asserted-by":"publisher","DOI":"10.1177\/1078155218818237"},{"key":"e_1_2_13_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.clcc.2015.12.008"},{"key":"e_1_2_13_16_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41598\u2010022\u201010008\u20102"},{"key":"e_1_2_13_17_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41598\u2010025\u201094105\u2010y"},{"key":"e_1_2_13_18_1","doi-asserted-by":"publisher","DOI":"10.3332\/ecancer.2023.1586"},{"key":"e_1_2_13_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.clcc.2018.11.001"},{"key":"e_1_2_13_20_1","doi-asserted-by":"publisher","DOI":"10.1002\/cpt.2444"},{"key":"e_1_2_13_21_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00280\u2010019\u201003837\u2010y"},{"key":"e_1_2_13_22_1","unstructured":"Lexi\u2010Comp \u201cLexicomp Online: Interactions \u201d(2023)."},{"key":"e_1_2_13_23_1","unstructured":"Analytics TH \u201cMICROMEDEX Drug Interactions \u201dwww.micromedexsolutions.com."},{"key":"e_1_2_13_24_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1470\u20102045(20)30527\u20101"},{"key":"e_1_2_13_25_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10620\u2010015\u20103642\u20108"}],"container-title":["International Journal of Cancer"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ijc.70754","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/ijc.70754","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ijc.70754","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T04:20:34Z","timestamp":1790050834000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/ijc.70754"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9,21]]},"references-count":24,"alternative-id":["10.1002\/ijc.70754"],"URL":"https:\/\/doi.org\/10.1002\/ijc.70754","archive":["Portico"],"relation":{},"ISSN":["0020-7136","1097-0215"],"issn-type":[{"value":"0020-7136","type":"print"},{"value":"1097-0215","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,9,21]]},"assertion":[{"value":"2026-03-23","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-09-14","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-09-21","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"ijc.70754"}}