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Antibiotic Treatment is an Independent Poor Risk Factor in NSCLC But Not in Melanoma Patients Who had Received Anti-PD-1/L1 Monotherapy

Hannes Vihinen (University of Turku, Turku University Hospital), Artturi Jokinen (University of Turku, Turku University Hospital), Teemu D. Laajala (University of Turku), Nesna Wahid (Vaasa Central Hospital), Lotta Peltola (Vaasa Central Hospital), Tiia Kettunen (Kuopio University Hospital), Aino Rönkä (Kuopio University Hospital), Leena Tiainen (Tampere University, Tampere University Hospital), Tanja Skyttä (Tampere University, Tampere University Hospital), Laura M. Kohtamäki (University of Helsinki, Helsinki University Hospital), Sanni K. A. Tulokas (University of Helsinki, Helsinki University Hospital), Hanna Karhapää (University of Helsinki, Helsinki University Hospital), Micaela Hernberg (University of Helsinki, Helsinki University Hospital), Maria Silvoniemi (University of Turku, Turku University Hospital), Kalle Mattila (University of Turku, Turku University Hospital)

Clinical Lung Cancer
Licence : CC BY

Résumé : BACKGROUND: Antibiotic treatment may reduce the efficacy of cancer immunotherapy by disrupting gut microbiome. We aimed to study the association of antibiotics and survival outcomes in advanced cutaneous melanoma and non-small-cell lung cancer (NSCLC) patients who had received anti-PD-1/L1 monotherapy. PATIENTS AND METHODS: A total of 222 melanoma and 199 NSCLC patients had received anti-PD-1/L1 monotherapy in 5 Finnish hospitals between January 2014 and December 2020. Clinical characteristics, antibiotic and corticosteroid treatment, and survival outcomes were retrospectively collected from hospital and national medical records. RESULTS: There were 32% of melanoma and 31% of NSCLC patients who had received antibiotic treatment (ABT) 3 months before to 1 month after the first anti-PD-1/L1 antibody infusion. In survival analyses, early antibiotic treatment was associated with inferior overall survival (OS) (ABT 19.2 [17.6-43.7] vs. no ABT 35.6 [29.3-NA] months, P = .033) but not with inferior progression-free survival (PFS) (ABT 5.8 [3.0-12.6] vs. no ABT 10.2 [7.7-15.3] months, P = .3) in melanoma patients and with inferior OS (ABT 8.6 [6.4-12.3] vs. no ABT 18.5 [15.1-21.6] months, P < .001) and PFS (ABT 2.8 [2.1-4.5] vs. no ABT 5.6 [4.4-8.0] months, P = .0081) in NSCLC patients. In multivariable analyses, ABT was not an independent risk-factor for inferior OS and PFS in melanoma but was associated with inferior OS (hazard ratio [HR] 2.12 [1.37-3.28]) and PFS (HR 1.65 [1.10-2.47]) in NSCLC after adjusted for other risk factors. CONCLUSIONS: Early ABT was an independent poor risk factor in NSCLC patients who had received anti-PD-1/L1 monotherapy but not in melanoma patients. The weight of ABT as a poor risk factor might depend on other prognostic factors in different cancers.

Publié le 25 Jan. 2023