Antibiotic use and the efficacy of immune checkpoint inhibitors in cancer patients: a pooled analysis of 2740 cancer patients
The gut microbiota plays a critical role in the anti-tumor immune response. There is increasing data showing that antibiotics (ATBs) change the composition of the gut microbiota and affect the efficacy of immune checkpoint inhibitors (ICIs). However, this is the first meta-analysis to evaluate the a...
| Main Authors: | , , , , , , , |
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| Format: | Article |
| Language: | English |
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Taylor & Francis Group
2019-12-01
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| Series: | OncoImmunology |
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| Online Access: | http://dx.doi.org/10.1080/2162402X.2019.1665973 |
| _version_ | 1819315634886934528 |
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| author | Xuan-Zhang Huang Peng Gao Yong-Xi Song Yan Xu Jing-Xu Sun Xiao-Wan Chen Jun-Hua Zhao Zhen-Ning Wang |
| author_facet | Xuan-Zhang Huang Peng Gao Yong-Xi Song Yan Xu Jing-Xu Sun Xiao-Wan Chen Jun-Hua Zhao Zhen-Ning Wang |
| author_sort | Xuan-Zhang Huang |
| collection | DOAJ |
| description | The gut microbiota plays a critical role in the anti-tumor immune response. There is increasing data showing that antibiotics (ATBs) change the composition of the gut microbiota and affect the efficacy of immune checkpoint inhibitors (ICIs). However, this is the first meta-analysis to evaluate the association between ATB use and ICI efficacy in cancer patients to provide a better understanding of the strength of this association. We performed a literature search for relevant studies that evaluated the relationship between ATB use and ICI efficacy using the PubMed, Embase, and conference databases. The primary outcomes consisted of overall survival (OS) and progression-free survival (PFS) measured by hazard ratios (HR) and corresponding 95% confidence intervals (CI). Subgroup and sensitivity analyses were also performed. A total of 19 eligible studies comprising 2,740 cancer patients treated with ICIs were included in the analysis. Our results indicated that ATB use was negatively associated with OS in cancer patients (HR = 2.37; 95% CI = 2.05–2.75; P < .001), without heterogeneity (I2 = 0.0%; P = .851). Moreover, ATB use significantly reduced PFS in patients treated with ICIs (HR = 1.84; 95% CI = 1.49–2.26; P < .001; I2 = 56.2%). Similar results were obtained in the subgroup analyses stratified by the time of ATB use and cancer type. Sensitivity analyses confirmed the stability of our results. Therefore, the findings of our meta-analysis indicated that ATB use is negatively associated with OS and PFS in cancer patients treated with ICI immunotherapy. |
| first_indexed | 2024-12-24T10:03:14Z |
| format | Article |
| id | doaj.art-016cf017940341cf96a42aa1d71b3a12 |
| institution | Directory Open Access Journal |
| issn | 2162-402X |
| language | English |
| last_indexed | 2024-12-24T10:03:14Z |
| publishDate | 2019-12-01 |
| publisher | Taylor & Francis Group |
| record_format | Article |
| series | OncoImmunology |
| spelling | doaj.art-016cf017940341cf96a42aa1d71b3a122022-12-21T17:00:57ZengTaylor & Francis GroupOncoImmunology2162-402X2019-12-0181210.1080/2162402X.2019.16659731665973Antibiotic use and the efficacy of immune checkpoint inhibitors in cancer patients: a pooled analysis of 2740 cancer patientsXuan-Zhang Huang0Peng Gao1Yong-Xi Song2Yan Xu3Jing-Xu Sun4Xiao-Wan Chen5Jun-Hua Zhao6Zhen-Ning Wang7The First Affiliated Hospital of China Medical UniversityThe First Affiliated Hospital of China Medical UniversityThe First Affiliated Hospital of China Medical UniversityThe First Affiliated Hospital of China Medical UniversityThe First Affiliated Hospital of China Medical UniversityThe First Affiliated Hospital of China Medical UniversityThe First Affiliated Hospital of China Medical UniversityThe First Affiliated Hospital of China Medical UniversityThe gut microbiota plays a critical role in the anti-tumor immune response. There is increasing data showing that antibiotics (ATBs) change the composition of the gut microbiota and affect the efficacy of immune checkpoint inhibitors (ICIs). However, this is the first meta-analysis to evaluate the association between ATB use and ICI efficacy in cancer patients to provide a better understanding of the strength of this association. We performed a literature search for relevant studies that evaluated the relationship between ATB use and ICI efficacy using the PubMed, Embase, and conference databases. The primary outcomes consisted of overall survival (OS) and progression-free survival (PFS) measured by hazard ratios (HR) and corresponding 95% confidence intervals (CI). Subgroup and sensitivity analyses were also performed. A total of 19 eligible studies comprising 2,740 cancer patients treated with ICIs were included in the analysis. Our results indicated that ATB use was negatively associated with OS in cancer patients (HR = 2.37; 95% CI = 2.05–2.75; P < .001), without heterogeneity (I2 = 0.0%; P = .851). Moreover, ATB use significantly reduced PFS in patients treated with ICIs (HR = 1.84; 95% CI = 1.49–2.26; P < .001; I2 = 56.2%). Similar results were obtained in the subgroup analyses stratified by the time of ATB use and cancer type. Sensitivity analyses confirmed the stability of our results. Therefore, the findings of our meta-analysis indicated that ATB use is negatively associated with OS and PFS in cancer patients treated with ICI immunotherapy.http://dx.doi.org/10.1080/2162402X.2019.1665973antibioticsimmune checkpoint inhibitorsimmunotherapyoverall survivalprogression-free survival |
| spellingShingle | Xuan-Zhang Huang Peng Gao Yong-Xi Song Yan Xu Jing-Xu Sun Xiao-Wan Chen Jun-Hua Zhao Zhen-Ning Wang Antibiotic use and the efficacy of immune checkpoint inhibitors in cancer patients: a pooled analysis of 2740 cancer patients OncoImmunology antibiotics immune checkpoint inhibitors immunotherapy overall survival progression-free survival |
| title | Antibiotic use and the efficacy of immune checkpoint inhibitors in cancer patients: a pooled analysis of 2740 cancer patients |
| title_full | Antibiotic use and the efficacy of immune checkpoint inhibitors in cancer patients: a pooled analysis of 2740 cancer patients |
| title_fullStr | Antibiotic use and the efficacy of immune checkpoint inhibitors in cancer patients: a pooled analysis of 2740 cancer patients |
| title_full_unstemmed | Antibiotic use and the efficacy of immune checkpoint inhibitors in cancer patients: a pooled analysis of 2740 cancer patients |
| title_short | Antibiotic use and the efficacy of immune checkpoint inhibitors in cancer patients: a pooled analysis of 2740 cancer patients |
| title_sort | antibiotic use and the efficacy of immune checkpoint inhibitors in cancer patients a pooled analysis of 2740 cancer patients |
| topic | antibiotics immune checkpoint inhibitors immunotherapy overall survival progression-free survival |
| url | http://dx.doi.org/10.1080/2162402X.2019.1665973 |
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