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Antibiotic Usage Reduced Overall Survival by over 70% in Non-small Cell Lung Cancer Patients on Anti-PD-1 Immunotherapy
Kazuyuki Hamada (SHOWA Medical University, University of California San Diego), Kiyoshi Yoshimura (SHOWA Medical University), Yuya Hirasawa (SHOWA Medical University), Masahiro Hosonuma (SHOWA Medical University), Masakazu Murayama (SHOWA Medical University), Yoichiro Narikawa (SHOWA Medical University), Hirotsugu Ariizumi (SHOWA Medical University), Ryotaro Ohkuma (SHOWA Medical University), Midori Shida (SHOWA Medical University), Yutaro Kubota (SHOWA Medical University), SATOSHI MATSUKUMA (SHOWA Medical University), Tomoyuki Ishiguro (SHOWA Medical University), Takehiko Sambe (SHOWA Medical University), Atsushi Horiike (SHOWA Medical University), Atsuo Kuramasu (SHOWA Medical University), Satoshi Wada (SHOWA Medical University), Junji Tsurutani (SHOWA Medical University), Eisuke Inoue (SHOWA Medical University), Naoki Uchida (SHOWA Medical University), Yuji Kiuchi (SHOWA Medical University), Shinichi Kobayashi (SHOWA Medical University), Robert M. Hoffman (University of California San Diego, AntiCancer (United States)), Takuya Tsunoda (SHOWA Medical University)
Abstract: BACKGROUND/AIM: There is an increasing use of immunotherapy for non-small cell lung cancer (NSCLC) patients. The present study analysed the effect of antibiotic use on the outcome of NSCLC patients undergoing treatment with anti-programmed cell death-1 (anti-PD-1) immunotherapy. PATIENTS AND METHODS: This was a retrospective study of 69 NSCLC patients. Eighteen out of 69 patients received antibiotics within 21 days before or within 21 days after start of anti-PD-1 therapy. RESULTS: Patients treated with anti-PD-1 antibodies receiving antibiotics had greatly decreased objective response rate (ORR), overall survival (OS) and progression-free survival (PFS) compared to those who did not use antibiotics. Multivariate analysis showed that antibiotic treatment of patients on anti-PD-1 antibody therapy was an independent negative predictive factor of PFS; however, it was not a significant independent predictive factor of OS. CONCLUSION: Use of antibiotics within 21 days before and after anti-PD-1 treatment initiation in patients with NSCLC strongly reduced OS and PFS, suggesting the two treatments should not be combined.