| 論文種別 | 原著(症例報告除く) |
| 言語種別 | 英語 |
| 査読の有無 | その他(不明) |
| 表題 | Effect of Butyrate-Producing Enterobacteria and Proton Pump Inhibitors on Advanced Hepatocellular Carcinoma Treatment With Durvalumab and Tremelimumab. |
| 掲載誌名 | 正式名：JGH open : an open access journal of gastroenterology and hepatology 略 称：JGH Open ISSNコード：23979070/23979070 |
| 掲載区分 | 国外 |
| 巻・号・頁 | 10(1),pp.e70346 |
| 著者・共著者 | Kazuhiro Nouso, Akiko Wakuta, Shohei Shiota, Rio Fujita, Kazuya Kariyama, Atsushi Hiraoka, Masanori Atsukawa, Joji Tani, Toshifumi Tada, Shinichiro Nakamura, Kazuto Tajiri, Masaki Kaibori, Masashi Hirooka, Ei Itobayashi, Satoru Kakizaki, Atsushi Naganuma, Toru Ishikawa, Michitaka Imai, Tomoko Aoki, Hironori Tanaka, Takeshi Hatanaka, Kunihiko Tsuji, Kazuhito Kawata, Koichi Takaguchi, Akemi Tsutsui, Chikara Ogawa, Hironori Ochi, Yutaka Yata, Hidekatsu Kuroda, Tomomitsu Matono, Satoshi Yasuda, Hidenori Toyoda, Hiroko Iijima, Masatoshi Kudo, Takashi Kumada |
| 発行年月 | 2026/01 |
| 概要 | AIM:The gut microbiome modulates immune responses, and butyrate-producing bacteria have been linked to improved immune checkpoint inhibitor (ICI) efficacy. Conversely, proton pump inhibitors (PPIs) may negatively impact ICI outcomes by altering gut microbiota. This study aims to elucidate their effects in hepatocellular carcinoma (HCC).METHODS:This retrospective multicenter cohort study included 208 HCC patients treated with durvalumab plus tremelimumab at 25 hospitals in Japan. Patients were classified into a butyric acid group (n = 27), who ingested drugs containing butyrate-producing enterobacteria, and a non-butyric acid group (n = 181), as well as a PPI group (n = 107) and a non-PPI group (n = 101). Overall survival (OS) was analyzed using inverse probability of treatment weighting, and risk factors were assessed with Cox proportional hazards modeling. Tumor response was evaluated by RECIST v1.1.RESULTS:No significant OS differences were observed between the butyric acid and non-butyric acid groups (p = 0.921), or between PPI and non-PPI groups (p = 0.917). The objective response rate was 3.7% in the butyric acid group versus 15.5% in the non-butyric acid group (p = 0.543) and 15.8% in the PPI group versus 12.1% in the non-PPI group (p = 0.222). Disease control rates were comparable. Multivariate analysis identified ECOG performance status (p = 0.019) and ALBI score (p < 0.001) as independent prognostic factors, while butyrate-producing bacteria and PPI use were not associated with survival outcomes.CONCLUSION:Neither butyrate-producing bacteria nor PPI use significantly influenced the efficacy of durvalumab plus tremelimumab in HCC. The liver's immunotolerant microenvironment may limit the impact of microbiome modulation on ICI efficacy. |
| DOI | 10.1002/jgh3.70346 |
| PMID | 41607410 |