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Even though the patients with metastatic RCC (mRCC) are often exposed to concomitant medications in parallel with anticancer agents, the impact of such co-medications remains insufficiently explored. The aim of this study was to investigate the impact of the use of proton pump inhibitors (PPIs) and\/or cardiovascular medication on the outcomes of patients with mRCC receiving nivolumab. Clinical data of patients with mRCC treated with nivolumab monotherapy were retrospectively analyzed with a focus on the association between progression-free survival (PFS) or overall survival (OS) and the use of common co-medications including PPIs, acetylsalicylic acid, statins, and antihypertensives. In total, 343 patients with mRCC were included. The median PFS and OS were 4.8 (95% CI 3.9\u20136.0) and 15.5 (95% CI 10.7\u201319.6) months vs. 9.7 (95% CI 7.6\u201312.2) and 29.8 (95% CI 23.7\u201333.1) months (\n                    <jats:italic>p<\/jats:italic>\n                    \u2009&lt;\u20090.001 and\n                    <jats:italic>p<\/jats:italic>\n                    \u2009&lt;\u20090.001) for PPI users and non-users, respectively. In the Cox multivariate analysis, the use of PPIs remained a significant factor predicting both inferior PFS (HR\u2009=\u20091.870 [95% CI 1.440\u20132.428],\n                    <jats:italic>p\u2009&lt;<\/jats:italic>\n                    \u20090.001) and OS (HR\u2009=\u20091.674 [95% CI 1.235\u20132.270],\n                    <jats:italic>p<\/jats:italic>\n                    \u2009=\u20090.001).). We did not find any impact of the basic classes of antihypertensive drugs, statins, or acetylsalicylic acid on the survival outcomes. Present study results demonstrate the negative impact of concomitant PPI use on PFS and OS, whereas neither statins nor antihypertensive medications had a significant impact on survival outcomes in patients with mRCC receiving nivolumab monotherapy.\n                  <\/jats:p>","DOI":"10.1007\/s10585-025-10347-0","type":"journal-article","created":{"date-parts":[[2025,8,2]],"date-time":"2025-08-02T05:26:08Z","timestamp":1754112368000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Impact of concomitant use of proton pump inhibitors or cardiovascular medication on survival outcomes of patients with metastatic renal cell carcinoma treated with nivolumab"],"prefix":"10.1007","volume":"42","author":[{"given":"Ond\u0159ej","family":"Fiala","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Petr","family":"Ho\u0161ek","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michaela","family":"Tkadlecov\u00e1","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bohuslav","family":"Melichar","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ane\u017eka","family":"Zem\u00e1nkov\u00e1","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jind\u0159ich","family":"Kopeck\u00fd","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michal","family":"Vo\u010dka","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martin","family":"Mat\u011bj\u016f","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Radka","family":"Lohynsk\u00e1","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dominika","family":"\u0160ikov\u00e1","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Petr","family":"Str\u00e1nsk\u00fd","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hana","family":"\u0160tudentov\u00e1","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martina","family":"Spisarov\u00e1","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hana","family":"Nov\u00e1kov\u00e1","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter","family":"Priester","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dominika","family":"Kry\u0161tofov\u00e1","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lucie","family":"Grmelov\u00e1","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tom\u00e1\u0161","family":"B\u00fcchler","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexandr","family":"Poprach","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,8,2]]},"reference":[{"key":"10347_CR1","doi-asserted-by":"publisher","first-page":"79","DOI":"10.14740\/wjon1279","volume":"11","author":"SA Padala","year":"2020","unstructured":"Padala SA, Barsouk A, Thandra KC, Saginala K, Mohammed A, Vakiti A et al (2020) Epidemiology of renal cell carcinoma. 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Adequate information was given to eligible patients by the principal investigator or co-investigators at each participating center and in accordance with local regulations. The declaration of informed consent was personally signed and dated by the subject, and by the investigator\/person designated by the investigator to conduct the informed consent discussion.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent to participate"}},{"value":"Ond\u0159ej Fiala received honoraria from Novartis, Janssen, Merck, BMS, MSD, Pierre Fabre, and Pfizer for consultations and lectures unrelated to this project. Bohuslav Melichar received honoraria from Novartis, Pfizer, Bayer-Schering, Astellas, and Roche for lectures and advisory boards unrelated to this project. Jind\u0159ich Kopeck\u00fd has received consulting fees from Bristol Myers Squibb, Novartis, Pfizer, Merck, MSD, Ipsen; payment or honoraria for lectures, presentations, speakers\u2019 bureaus, manuscript writing, or educational events from Ipsen, Bristol Myers Squibb, MSD, Merck, Novartis and Pfizer. All of the above are unrelated to the present paper. Michal Vo\u010dka has received consulting fees from Merck, Roche, MSD; payment or honoraria for lectures, presentations, speakers\u2019 bureaus, manuscript writing, or educational events from BMS, MSD, Merck, Novartis, AstraZeneca, Roche and Pfizer. All of the above are unrelated to the present paper. Martin Mat\u011bj\u016f has received consulting fees from Novartis, MSD, Astellas; payment or honoraria for lectures, presentations, speakers\u2019 bureaus, manuscript writing, or educational events from Ipsen, BMS, MSD, Merck, Novartis, Eisa, AstraZeneca, Roche and Pfizer. All of the above are unrelated to the present paper. Radka Lohynsk\u00e1 has received payment or honoraria for lectures, presentations, speakers\u2019 bureaus, manuscript writing, or educational events from Roche, Janssen, Bristol Myers Squibb, MSD and Merck. All of the above are unrelated to the present paper. Tom\u00e1\u0161 B\u00fcchler has received research support: AstraZeneca, Roche, Bristol Myers Squibb, Exelixis, Merck KGaA, MSD, and Novartis; consulting fees from Bristol Myers Squibb, Astellas, Janssen, and Sanofi\/Aventis; payment or honoraria for lectures, presentations, speakers\u2019 bureaus, manuscript writing, or educational events from Ipsen, Bristol Myers Squibb, AstraZeneca, Roche, Servier, Accord, MSD, and Pfizer. All unrelated to the present paper. All of the above are unrelated to the present paper. Hana \u0160tudentov\u00e1 has received consulting fees from Bristol Myers Squibb, MSD, Ipsen, Novartis, Astellas and Janssen; payment or honoraria for lectures, presentations, speakers\u2019 bureaus, or educational events from Ipsen, Merck, Bristol Myers Squibb, Novartis, MSD, and Pfizer. All of the above are unrelated to the present paper. Alexandr Poprach has received consulting fees from Bristol Myers Squibb, Roche, Zentiva, Novartis, Pfizer, Merck, MSD, Ipsen; payment or honoraria for lectures, presentations, speakers\u2019 bureaus, manuscript writing, or educational events from Ipsen, Bristol Myers Squibb, MSD, Merck, Novartis and Pfizer. All of the above are unrelated to the present paper. Other authors declare no potential conflict of interest.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"43"}}