Effect of antibiotic treatment on immune checkpoint inhibitors efficacy in patients with advanced non-small cell lung cancer

• Published in: Lung cancer (Amsterdam, Netherlands) Netherlands), 2023-10, Vol.184, p.107347-107347, Article 107347
• Main Authors: Alkan Şen, Gülin, Şentürk Öztaş, Nihan, Değerli, Ezgi, Can, Günay, Turna, Hande, Özgüroğlu, Mustafa
• Format: Article
• Language: English
• Subjects: Antibiotics; Immune check point inhibitors; Non small cell lung cancer
• ISSN: 0169-5002; 1872-8332
• DOI: 10.1016/j.lungcan.2023.107347

•The intestinal microbiota is a predictor of immunotherapy efficacy.•Antibiotics in the early phase of ICIs treatment are associated with decreased OS, PFS, and ORR in patients with NSCLC.•The impact of ATB correlates with the timeframe of their administration rather than multiple courses of usage.•Microbiome-modulating therapies that reverse antibiotic-induced dysbiosis are needed. Gut microbiotaplays a crucial role in immune response. Recent data have shown that antibiotic (ATB) usage influences efficacy of immune check point inhibitors (ICIs) via altering microbiota of the gut. We retrospectively analyzed patients with advanced non-small cell lung cancer (NSCLC) treated with ICIs as monotherapy or combination with chemotherapy (ChT) at the one academic center. Those receiving ATB for the first 12 weeks of the initiation of ICIs were compared with those who did not. The primary objective of this study was to assess the impact of ATB use on overall survival (OS), progression-free survival (PFS), and objective response rate (ORR) during ICIs therapy. 90 patients were included in our analysis. Of these 90 patients, 27 (30%) received ATB in the first 12 weeks of the treatment. In patients who received ATB in the first 12 weeks of ICIs administration, PFS was significantly shorter (4.9 vs. 24.8 months, HR 2.52, 95% CI (1.52–4.18), p