{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,27]],"date-time":"2026-09-27T03:23:00Z","timestamp":1790479380682,"version":"4.1.0"},"reference-count":74,"publisher":"MDPI AG","issue":"5","license":[{"start":{"date-parts":[[2022,2,24]],"date-time":"2022-02-24T00:00:00Z","timestamp":1645660800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cancers"],"abstract":"<jats:p>Multikinase inhibitors (MKIs), and particularly tyrosine kinase inhibitors (TKIs) and immune checkpoint inhibitors (CPIs), are currently some of the major breakthroughs in cancer treatment. Proton pump inhibitors (PPIs) revolutionised the treatment of acid-related diseases, but are frequently overused for epigastric pain or heartburn. However, long-term acid suppression from using PPIs may lead to safety concerns, and could have a greater impact in cancer patients undergoing therapy, like bone fractures, renal toxicities, enteric infections, and micronutrient deficiencies (iron and magnesium). Moreover, acid suppression may also affect the pharmacokinetics of drugs (at least during acid suppression) and decrease the absorption of many molecularly-targeted anticancer therapies, which are mostly weak bases with pH-dependent absorption. This type of drug-drug interaction may have detrimental effects on efficacy, with major clinical impacts described for some orally administrated targeted therapies (erlotinib, gefitinib, pazopanib, palbociclib), and conflicting results with many others, including capecitabine. Furthermore, the long-term use of PPIs results in severe alterations to the gut microbiome and recent retrospective analyses have shown that the benefit of using CPIs was suppressed in patients treated with PPIs. These very expensive drugs are of great importance because of their efficacy. As the use of PPIs is not essential, we must apply the precautionary principle. All these data should encourage medical oncologists to refrain from prescribing PPIs, explaining to patients the risks of interaction in order to prevent inappropriate prescription by another physician.<\/jats:p>","DOI":"10.3390\/cancers14051156","type":"journal-article","created":{"date-parts":[[2022,2,23]],"date-time":"2022-02-23T22:54:02Z","timestamp":1645656842000},"page":"1156","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":20,"title":["Long-Term Use of Proton Pump Inhibitors in Cancer Patients: An Opinion Paper"],"prefix":"10.3390","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6305-8953","authenticated-orcid":false,"given":"Jean-Luc","family":"Raoul","sequence":"first","affiliation":[{"name":"Department of Medical Oncology, Institut de Canc\u00e9rologie de l\u2019Ouest, 44805 Saint-Herblain, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8289-7741","authenticated-orcid":false,"given":"Julien","family":"Edeline","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology, Centre E Marquis, 35000 Rennes, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Victor","family":"Simmet","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology, Institut de Canc\u00e9rologie de l\u2019Ouest, 49055 Angers, France"},{"name":"Department of Medical Oncology, Centre Hospitalier de Cholet, 49300 Cholet, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4289-8483","authenticated-orcid":false,"given":"Camille","family":"Moreau-Bachelard","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology, Institut de Canc\u00e9rologie de l\u2019Ouest, 44805 Saint-Herblain, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1868-3260","authenticated-orcid":false,"given":"Marine","family":"Gilabert","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology, Centre Hospitalier Universitaire Vaudois, 1011 Lausanne, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5273-0561","authenticated-orcid":false,"given":"Jean-S\u00e9bastien","family":"Fr\u00e9nel","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology, Institut de Canc\u00e9rologie de l\u2019Ouest, 44805 Saint-Herblain, France"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2022,2,24]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"35","DOI":"10.1053\/j.gastro.2017.04.047","article-title":"Complications of Proton Pump Inhibitor Therapy","volume":"153","author":"Vaezi","year":"2017","journal-title":"Gastroenterology"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"2","DOI":"10.1136\/bmj.39406.449456.BE","article-title":"Overprescribing proton pump inhibitors","volume":"336","author":"Forgacs","year":"2008","journal-title":"BMJ"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"31","DOI":"10.1016\/j.ejim.2016.01.025","article-title":"Appropriateness of Proton Pump Inhibitor (PPI) prescription in patients admitted to hospital: Attitudes of general practitioners and hospital physicians in Italy","volume":"30","author":"Lodato","year":"2016","journal-title":"Eur. 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