The impact of antibiotic use on clinical features and survival outcomes of cancer patients treated with immune checkpoint inhibitors
BackgroundNowadays, 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.MethodsOur research included retrospective studies and a randomized cli...
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| Format: | Article |
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Frontiers Media S.A.
2022-07-01
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| Series: | Frontiers in Immunology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fimmu.2022.968729/full |
| _version_ | 1818161484119670784 |
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| author | Jiaxin Zhou Jiaxin Zhou Guowei Huang Wan-Ching Wong Da-hai Hu Jie-wen Zhu Ruiman Li Hong Zhou |
| author_facet | Jiaxin Zhou Jiaxin Zhou Guowei Huang Wan-Ching Wong Da-hai Hu Jie-wen Zhu Ruiman Li Hong Zhou |
| author_sort | Jiaxin Zhou |
| collection | DOAJ |
| description | BackgroundNowadays, 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.MethodsOur 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.ResultsOur 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 broad-spectrum ATB class was strongly associated with poor PFS.ConclusionIn 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. |
| first_indexed | 2024-12-11T16:18:30Z |
| format | Article |
| id | doaj.art-d9f41b3a58a64578ae0a5f64248ce8d9 |
| institution | Directory Open Access Journal |
| issn | 1664-3224 |
| language | English |
| last_indexed | 2024-12-11T16:18:30Z |
| publishDate | 2022-07-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Immunology |
| spelling | doaj.art-d9f41b3a58a64578ae0a5f64248ce8d92022-12-22T00:58:54ZengFrontiers Media S.A.Frontiers in Immunology1664-32242022-07-011310.3389/fimmu.2022.968729968729The impact of antibiotic use on clinical features and survival outcomes of cancer patients treated with immune checkpoint inhibitorsJiaxin Zhou0Jiaxin Zhou1Guowei Huang2Wan-Ching Wong3Da-hai Hu4Jie-wen Zhu5Ruiman Li6Hong Zhou7Department of Obstetrics and Gynecology, The First Affiliated Hospital of Jinan University, Guangzhou, ChinaInternational School, Jinan University, Guangzhou, ChinaShunde Hospital Affiliated to Jinan University, Guangzhou, ChinaDepartment of General Surgery, The First Affiliated Hospital of Jinan University, Guangzhou, ChinaInternational School, Jinan University, Guangzhou, ChinaCollege of Science and Engineering, Jinan University, Guangzhou, ChinaDepartment of Obstetrics and Gynecology, The First Affiliated Hospital of Jinan University, Guangzhou, ChinaDepartment of Obstetrics and Gynecology, The First Affiliated Hospital of Jinan University, Guangzhou, ChinaBackgroundNowadays, 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.MethodsOur 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.ResultsOur 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 broad-spectrum ATB class was strongly associated with poor PFS.ConclusionIn 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.https://www.frontiersin.org/articles/10.3389/fimmu.2022.968729/fullantibioticimmune checkpoint inhibitorPD-1PD-L1survival outcomes |
| spellingShingle | Jiaxin Zhou Jiaxin Zhou Guowei Huang Wan-Ching Wong Da-hai Hu Jie-wen Zhu Ruiman Li Hong Zhou The impact of antibiotic use on clinical features and survival outcomes of cancer patients treated with immune checkpoint inhibitors Frontiers in Immunology antibiotic immune checkpoint inhibitor PD-1 PD-L1 survival outcomes |
| title | The impact of antibiotic use on clinical features and survival outcomes of cancer patients treated with immune checkpoint inhibitors |
| title_full | The impact of antibiotic use on clinical features and survival outcomes of cancer patients treated with immune checkpoint inhibitors |
| title_fullStr | The impact of antibiotic use on clinical features and survival outcomes of cancer patients treated with immune checkpoint inhibitors |
| title_full_unstemmed | The impact of antibiotic use on clinical features and survival outcomes of cancer patients treated with immune checkpoint inhibitors |
| title_short | The impact of antibiotic use on clinical features and survival outcomes of cancer patients treated with immune checkpoint inhibitors |
| title_sort | impact of antibiotic use on clinical features and survival outcomes of cancer patients treated with immune checkpoint inhibitors |
| topic | antibiotic immune checkpoint inhibitor PD-1 PD-L1 survival outcomes |
| url | https://www.frontiersin.org/articles/10.3389/fimmu.2022.968729/full |
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