Detrimental effect of an early exposure to antibiotics on the outcomes of immunotherapy in a multi-tumor cohort of patients.

Autor:	Guerrero P; Department of Medical Oncology, Ramón y Cajal University Hospital, 28034 Madrid, Spain., Albarrán V; Department of Medical Oncology, Ramón y Cajal University Hospital, 28034 Madrid, Spain., González-Merino C; Department of Medical Oncology, Ramón y Cajal University Hospital, 28034 Madrid, Spain., García de Quevedo C; Department of Medical Oncology, Ramón y Cajal University Hospital, 28034 Madrid, Spain., Sotoca P; Department of Medical Oncology, Ramón y Cajal University Hospital, 28034 Madrid, Spain., Chamorro J; Department of Medical Oncology, Ramón y Cajal University Hospital, 28034 Madrid, Spain., Rosero DI; Department of Medical Oncology, Ramón y Cajal University Hospital, 28034 Madrid, Spain., Barrill A; Department of Medical Oncology, Ramón y Cajal University Hospital, 28034 Madrid, Spain., Alía V; Department of Medical Oncology, Ramón y Cajal University Hospital, 28034 Madrid, Spain., Calvo JC; Department of Medical Oncology, Ramón y Cajal University Hospital, 28034 Madrid, Spain., Moreno J; Department of Medical Oncology, Ramón y Cajal University Hospital, 28034 Madrid, Spain., Pérez de Aguado P; Department of Medical Oncology, Ramón y Cajal University Hospital, 28034 Madrid, Spain., Álvarez-Ballesteros P; Department of Medical Oncology, Ramón y Cajal University Hospital, 28034 Madrid, Spain., San Román M; Department of Medical Oncology, Ramón y Cajal University Hospital, 28034 Madrid, Spain., Serrano JJ; Department of Medical Oncology, Ramón y Cajal University Hospital, 28034 Madrid, Spain., Soria A; Department of Medical Oncology, Ramón y Cajal University Hospital, 28034 Madrid, Spain., Olmedo ME; Department of Medical Oncology, Ramón y Cajal University Hospital, 28034 Madrid, Spain., Saavedra C; Department of Medical Oncology, Ramón y Cajal University Hospital, 28034 Madrid, Spain., Cortés A; Department of Medical Oncology, Ramón y Cajal University Hospital, 28034 Madrid, Spain., Gómez A; Department of Medical Oncology, Ramón y Cajal University Hospital, 28034 Madrid, Spain., Lage Y; Department of Medical Oncology, Ramón y Cajal University Hospital, 28034 Madrid, Spain., Ruiz Á; Department of Medical Oncology, Ramón y Cajal University Hospital, 28034 Madrid, Spain., Ferreiro MR; Department of Medical Oncology, Ramón y Cajal University Hospital, 28034 Madrid, Spain., Longo F; Department of Medical Oncology, Ramón y Cajal University Hospital, 28034 Madrid, Spain., Guerra E; Department of Medical Oncology, Ramón y Cajal University Hospital, 28034 Madrid, Spain., Martínez-Delfrade Í; Department of Medical Oncology, Ramón y Cajal University Hospital, 28034 Madrid, Spain., Garrido P; Department of Medical Oncology, Ramón y Cajal University Hospital, 28034 Madrid, Spain., Gajate P; Department of Medical Oncology, Ramón y Cajal University Hospital, 28034 Madrid, Spain.
Jazyk:	angličtina
Zdroj:	The oncologist [Oncologist] 2024 Oct 19. Date of Electronic Publication: 2024 Oct 19.
DOI:	10.1093/oncolo/oyae284
Abstrakt:	Background: Immune checkpoint inhibitors (ICI) have changed the therapeutic landscape of many solid tumors. Modulation of the intestinal microbiota by antibiotics (Abx) has been suggested to impact on ICI outcomes. Methods: Retrospective analysis of 475 patients with advanced solid tumors treated with ICI from 2015 to 2022. For each patient, the use of Abx was recorded from 1 month before ICI initiation until disease progression or death. The impact of Abx on objective response rates (ORR), disease control rates (DCR), progression-free survival (PFS), and overall survival (OS) was analyzed. Kaplan-Meier and log-rank tests were used to compare survival outcomes. Results: In total 475 patients with advanced solid tumors were evaluated. Median age was 67.5 years and performance status (PS) was 0-1 in 84.6%. 66.5% of patients received Abx during treatment with ICI, mainly beta-lactams (53.8%) and quinolones (35.9%). The early exposure to Abx (from 60 days before to 42 days after the first cycle of ICI) was associated with a lower ORR (27.4% vs 39.4%; P < .01), a lower DCR (37.3% vs 57.4%; P < .001), lower PFS (16.8 m vs 27.8 m; HR 0.66; P < .001]) and lower OS (2.5 m vs 6.6 m; HR 0.68; P = .001]). The negative impact of Abx on OS and PFS was confirmed by a multivariable analysis. This effect was not observed among patients receiving Abx after 6 weeks from ICI initiation. Conclusions: Our results validate the hypothesis of a detrimental effect of an early exposure to Abxon the efficacy of ICI in a multi-tumor cohort of patients. (© The Author(s) 2024. Published by Oxford University Press.)
Databáze:	MEDLINE
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