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This is a combination of **nirogacestat** (a small molecule gamma secretase inhibitor mainly used in desmoid tumors) and **rabeprazole** (a proton pump inhibitor used for acid-related gastrointestinal diseases). Nirogacestat inhibits gamma secretase and thereby blocks activation of the Notch receptor, impeding tumor growth. Rabeprazole suppresses gastric acid secretion by irreversible inhibition of the gastric proton pump H+/K+ ATPase. The combination has been studied in a phase 1 setting to evaluate pharmacokinetic and safety interactions, with specific relevance for the impact of gastric acid suppression on nirogacestat absorption and exposure[1][4][5].
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