Abstract
Purpose
In this study, we test the hypothesis that the use of ATB reduces the efficacy of PD(L)1-targeting mAb.
Methods
We included patients with locally advanced, inoperable or metastatic, EGFR wildtype and ALK-negative non-small-cell lung cancer (NSCLC) who received a PD(L)1 targeting mAb (immune checkpoint inhibitor, ICI) between January 2013 and December 2017. The primary study objective was to assess the predictive impact of ATB use within 2 months prior to starting ICI treatment on overall survival from the time of starting ICI treatment (OS-ICI).
Results
33 out of 218 evaluable patients (15.1%) received ATB within 2 months prior to starting ICI treatment. The use of ATB prior to starting ICI was associated with a lower rate of radiological response (18.2 vs. 28.3%, respectively, P = 0.02). PFS was significantly shorter in patients receiving ATB within 2 months prior to ICI compared to those not receiving ATB (median PFS 1.4 vs. 5.5 months, HR = 2.22, P < 0.01). OS-ICI was significantly shorter in NSCLC patients receiving ATB within 2 months prior to ICI compared to those not receiving ATB (median OS-ICI 1.8 vs. 15.4 months, HR = 2.61, P < 0.01; adjusted HR = 3.73, P < 0.01).
Conclusion
The results of this study suggest that ATB may have a deleterious effect in patients with advanced NSCLC receiving ICI treatment, and more research seems to be justified to explore potential mechanisms.
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280_2019_3993_MOESM2_ESM.tif
Supplementary material 2 Overall survival from diagnosis of palliative NSCLC in patients receiving antibiotics (ATB) within 2 months prior to starting IO compared to no prior ATB (panel A), patients receiving ATB during IO compared to no ATB during IO (panel B), patients receiving ATB within 1 months after discontinuing IO compared to no ATB after IO (panel C) and patients receiving ATB prior and during IO compared to no ATB prior or during IO (panel D). HR = hazard ratio (TIFF 1332 kb)
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Schett, A., Rothschild, S.I., Curioni-Fontecedro, A. et al. Predictive impact of antibiotics in patients with advanced non small-cell lung cancer receiving immune checkpoint inhibitors. Cancer Chemother Pharmacol 85, 121–131 (2020). https://doi.org/10.1007/s00280-019-03993-1
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DOI: https://doi.org/10.1007/s00280-019-03993-1