The liver tumor immune microenvironment has been thought to possess a critical role in the development and progression of hepatocellular carcinoma (HCC). Despite the approval of immune checkpoint inhibitors (ICIs), such as programmed cell death receptor 1 (PD-1)/programmed cell death ligand 1 (PD-L1) and cytotoxic T lymphocyte associated protein 4 (CTLA-4) inhibitors, for several types of cancers, including HCC, liver metastases have shown evidence of resistance or poor response to immunotherapies. Radiation therapy (RT) has displayed evidence of immunosuppressive effects through the upregulation of immune checkpoint molecules post-treatment. However, it was revealed that the limitations of ICIs can be overcome through the use of RT, as it can reshape the liver immune microenvironment. Moreover, ICIs are able to overcome the RT-induced inhibitory signals, effectively restoring anti-tumor activity. Owing to the synergetic effect believed to arise from the combination of ICIs with RT, several clinical trials are currently ongoing to assess the efficacy and safety of this treatment for patients with HCC.

Aim: Tegoprazan, a potassium‐competitive acid blocker, is an acid‐suppressing medication under review as a potential alternative treatment in cases of erosive esophagitis. This systematic review and meta‐analysis assesses the efficacy and tolerability of tegoprazan compared to proton pump inhibitors, the current standard of care. Methods: Pubmed, Cochrane Library, Web of Science, Scopus, Embase, and Medline Ovid were systematically searched for articles up to November 25, 2025. Inclusion criteria selected RCTs that included patients with erosive esophagitis and studies of safety and efficacy, while exclusion criteria were defined by nonhuman studies, healthy patient populations, Helicobacter pylori ‐positive populations, and non‐RCT publication types. This review was registered with PROSPERO (CRD42024602209). Results: Out of 724 screened studies, 5 RCTs were selected for this review, with a total of 1386 patients. Tegoprazan efficacy outcomes were consistent with non‐inferiority when compared to PPIs in the healing of erosive esophagitis (risk ratio: 1.03, 95% confidence interval: 1.00–1.07), as confirmed endoscopically. Comparable tolerability was also demonstrated (rate ratio: 0.97, 95% confidence interval: 0.68–1.37), with a similar distribution of treatment‐emergent adverse events across treatment groups. Conclusions: Tegoprazan was non‐inferior to PPIs in both efficacy and tolerability, in accordance with the definition of non‐inferiority set by the RCTs. This supports its potential use as an alternative treatment in patients with erosive esophagitis.