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Broad-Spectrum Antibiotic Regimen Affects Survival in Patients Receiving Nivolumab for Non-Small Cell Lung Cancer. | LitMetric

AI Article Synopsis

  • Antibiotic use, specifically broad-spectrum antibiotics like piperacillin/tazobactam (PTZ), has been linked to shorter overall survival in non-small cell lung cancer (NSCLC) patients treated with the immune checkpoint inhibitor nivolumab.
  • A study analyzing 140 patients revealed that those on antibiotics had a significantly decreased survival rate compared to those not taking antibiotics, with factors like prolonged antibiotic therapy and high doses correlating with increased mortality.
  • While progression-free survival (PFS) showed no significant difference between patients on antibiotics and those who weren't, PFS was negatively impacted by the class of antibiotics and the length of therapy involving PTZ.

Article Abstract

Antibiotic-induced dysbiosis may affect the efficacy of immune checkpoint inhibitors. We investigated the impact of antibiotics on the clinical outcomes of nivolumab in patients with non-small cell lung cancer (NSCLC). Patients who received nivolumab for NSCLC between July 2015 and June 2018 and who were followed up until June 2020 were included in a retrospective cohort analysis. Of 140 eligible patients, 70 were on antibiotics. Overall survival (OS) was shorter in patients on antibiotics (ABX) compared to those not on antibiotics (NoABX) ( = 0.014). OS was negatively associated with piperacillin/tazobactam (PTZ) (HR = 3.31, 95% CI: 1.77-6.18), days of therapy (DOT) ≥ 2 weeks (HR = 2.56, 95% CI: 1.30-5.22) and DOT of PTZ. The defined daily dose (DDD) in PTZ (r = 0.27) and glycopeptides (r = 0.21) showed weak correlations with mortality. There was no difference in progression-free survival (PFS) between ABX and NoABX; however, PFS was negatively associated with the antibiotic class PTZ and DOT of PTZ. Therefore, the use of a broad-spectrum antibiotic, such as PTZ, the long-term use of antibiotics more than 2 weeks in total and the large amount of defined daily dose of specific antibiotics were associated with decreased survival in patients receiving nivolumab for NSCLC.

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Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8151442PMC
http://dx.doi.org/10.3390/ph14050445DOI Listing

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