The impact of antibiotic use on clinical features and survival outcomes of cancer patients treated with immune checkpoint inhibitors

被引:23
作者
Zhou, Jiaxin [1 ,2 ]
Huang, Guowei [3 ]
Wong, Wan-Ching [4 ]
Hu, Da-hai [2 ]
Zhu, Jie-wen [5 ]
Li, Ruiman [1 ]
Zhou, Hong [1 ]
机构
[1] Jinan Univ, Dept Obstet & Gynecol, Affiliated Hosp 1, Guangzhou, Peoples R China
[2] Jinan Univ, Int Sch, Guangzhou, Peoples R China
[3] Jinan Univ, Shunde Hosp, Guangzhou, Peoples R China
[4] Jinan Univ, Dept Gen Surg, Affiliated Hosp 1, Guangzhou, Peoples R China
[5] Jinan Univ, Coll Sci & Engn, Guangzhou, Peoples R China
来源
FRONTIERS IN IMMUNOLOGY | 2022年 / 13卷
关键词
antibiotic; immune checkpoint inhibitor; PD-1; PD-L1; survival outcomes; IMMUNOTHERAPY RESPONSE; CELL CARCINOMA; EFFICACY; THERAPY; CHEMOTHERAPY; MICROBIOME; PROGNOSIS;
D O I
10.3389/fimmu.2022.968729
中图分类号
R392 [医学免疫学]; Q939.91 [免疫学];
学科分类号
100102 ;
摘要
Background: Nowadays, immune checkpoint inhibitors (ICIs) have become one of the essential immunotherapies for cancer patients. However, the impact of antibiotic (ATB) use on cancer patients treated with ICIs remains controversial. Methods: Our research included retrospective studies and a randomized clinical trial (RCT) with cancer patients treated with ICIs and ATB, from the public database of PubMed, Web of Science, Embase, Cochrane, clinical trials, and JAMA. The survival outcomes included progression-free survival (PFS) and overall survival (OS). Meanwhile, hazard ratios (HRs) and 95% confidence intervals (CIs) were calculated, and subgroup analyses were performed to determine the concrete association between ATB use and the prognosis of cancer patients treated in ICIs. Results: Our results revealed that ATB use was associated with poor survival outcomes, including OS (HR: 1.94, 95% CI: 1.68-2.25, p <0.001) and PFS (HR: 1.83, 95% CI: 1.53-2.19, p <0.001). The subgroup analysis learned about the association between ATB use and the prognosis of cancer patients with ICI treatment, including 5 cancer types, 3 kinds of ICI, 5 different ATP windows, broad-spectrum ATB class, and ECOG score. ATB treatment was associated with poor OS of non-small-cell lung cancer (NSCLC), renal cell carcinoma (RCC), esophageal cancer (EC), and melanoma (MEL) in patients treated in ICIs, while non-small-cell lung cancer (NSCLC) and renal cell carcinoma (RCC) were associated with poor PFS. Meanwhile, it was strongly related to the ICI type and ATB window. Furthermore, it is firstly mentioned that the use of broadspectrum ATB class was strongly associated with poor PFS. Conclusion: In conclusion, our meta-analysis indicated that ATB use was significantly associated with poor OS and PFS of cancer patients treated with ICI immunotherapy, especially for patients with ATB use in the period of (-60 days; +30 days) near the initiation of ICI treatment. Also, different cancer types and the ICI type can also impact the survival outcome. This first reveals the strong relationship between the broad-spectrum ATB class and poor PFS. Still, more studies are needed for further study.
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页数:19
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