Antibiotic use influences outcomes in advanced pancreatic adenocarcinoma patients

• Published in: Cancer medicine (Malden, MA) MA), 2021-08, Vol.10 (15), p.5041-5050
• Main Authors: Mohindroo, Chirayu, Hasanov, Merve, Rogers, Jane E., Dong, Wenli, Prakash, Laura R., Baydogan, Seyda, Mizrahi, Jonathan D., Overman, Michael J., Varadhachary, Gauri R., Wolff, Robert A., Javle, Milind M., Fogelman, David R., Lotze, Michael T., Kim, Michael P., Katz, Matthew H.G., Pant, Shubham, Tzeng, Ching‐Wei D., McAllister, Florencia
• Format: Article
• Language: English
• Subjects: Adenocarcinoma; Adult; Aged; Aged, 80 and over; Anti-Bacterial Agents - therapeutic use; Antibiotics; Antineoplastic Agents - therapeutic use; autophagy; Bacterial Infections - drug therapy; Cancer therapies; Carcinoma, Pancreatic Ductal - microbiology; Carcinoma, Pancreatic Ductal - mortality; Carcinoma, Pancreatic Ductal - secondary; Carcinoma, Pancreatic Ductal - therapy; chemotherapeutic agents; Chemotherapy; Clinical Cancer Research; Colorectal cancer; Deoxycytidine - analogs & derivatives; Deoxycytidine - therapeutic use; Epidemiologic Methods; Female; Fluorouracil - therapeutic use; Gastrointestinal Microbiome - drug effects; Gemcitabine; Humans; immunity; Immunotherapy; Male; Medical prognosis; Metastases; Metastasis; Microbiomes; microbiota; Middle Aged; Multivariate Analysis; Pancreas; pancreatic adenocarcinoma; Pancreatic cancer; Pancreatic Neoplasms - microbiology; Pancreatic Neoplasms - mortality; Pancreatic Neoplasms - pathology; Pancreatic Neoplasms - therapy; Patients; Progression-Free Survival; Retrospective Studies; Software; Statistical analysis; Surgery; Survival; Time Factors; Treatment Outcome; Tumors
• ISSN: 2045-7634; 2045-7634
• DOI: 10.1002/cam4.3870

Recent studies defined a potentially important role of the microbiome in modulating pancreatic ductal adenocarcinoma (PDAC) and responses to therapies. We hypothesized that antibiotic usage may predict outcomes in patients with PDAC. We retrospectively analyzed clinical data of patients with resectable or metastatic PDAC seen at MD Anderson Cancer from 2003 to 2017. Demographic, chemotherapy regimen and antibiotic use, duration, type, and reason for indication were recorded. A total of 580 patients with PDAC were studied, 342 resected and 238 metastatic patients, selected retrospectively from our database. Antibiotic use, for longer than 48 hrs, was detected in 209 resected patients (61%) and 195 metastatic ones (62%). On resectable patients, we did not find differences in overall survival (OS) or progression‐free survival (PFS), based on antibiotic intake. However, in the metastatic cohort, antibiotic consumption was associated with a significantly longer OS (13.3 months vs. 9.0 months, HR 0.48, 95% CI 0.34–0.7, p = 0.0001) and PFS (4.4 months vs. 2 months, HR 0.48, 95% CI 0.34–0.68, p =