2023
DOI: 10.1001/jamanetworkopen.2023.4254
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Association of Antibiotic Receipt With Survival Among Patients With Metastatic Pancreatic Ductal Adenocarcinoma Receiving Chemotherapy

Abstract: ImportanceThe prognosis for patients with metastatic pancreatic ductal adenocarcinoma (PDAC) is dismal, due in part to chemoresistance. Bacteria-mediated mechanisms of chemoresistance suggest a potential role for antibiotics in modulating response to chemotherapy.ObjectiveTo evaluate whether use of peritreatment antibiotics is associated with survival among patients with metastatic PDAC treated with first-line gemcitabine or fluorouracil chemotherapy.Design, Setting, and ParticipantsUsing the population-based … Show more

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Cited by 23 publications
(23 citation statements)
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“…Studies have shown an increase of 11% in overall survival and a 16% improvement in cancer-specific survival for metastatic PDAC patients receiving gemcitabine in combination with antibiotics during chemotherapy. Conversely, similar benefits were not seen in patients treated with fluorouracil ( 39 ). This discrepancy implies that antibiotics may play a role in overcoming gemcitabine resistance caused by bacteria, potentially leading to better outcomes in PDAC treatment.…”
Section: Discussionmentioning
confidence: 96%
“…Studies have shown an increase of 11% in overall survival and a 16% improvement in cancer-specific survival for metastatic PDAC patients receiving gemcitabine in combination with antibiotics during chemotherapy. Conversely, similar benefits were not seen in patients treated with fluorouracil ( 39 ). This discrepancy implies that antibiotics may play a role in overcoming gemcitabine resistance caused by bacteria, potentially leading to better outcomes in PDAC treatment.…”
Section: Discussionmentioning
confidence: 96%
“…A higher ARG diversity within PDAC patients’ microbiome could have direct implications for treatment, as it may predispose to more frequent or severe bacterial infections that are resistant to standard antibiotics. Previous study found that oral antibiotics can activate antitumor immunity and suppress tumor burden in PDAC tumor-bearing mice [ 25 ], and clinical antibiotics can increase survival and progression-free survival of patients [ 18 , 26 ]. Although antibiotics are beneficial for PDAC, the accumulation of ARGs in the human symbiotic microbiome needs to be considered as antibiotic resistance has become a significant global health concern.…”
Section: Discussionmentioning
confidence: 99%
“…The presence of pathogenic bacteria has been proposed to contribute to systemic inflammation, which is a recognized risk factor for the development of PDAC. Further, Fulop et.al found that receipt of perichemotherapy antibiotics was associated with improved survival among patients treated with gemcitabine [ 18 ]. They think that antibiotics may modulate bacteria-mediated gemcitabine resistance and have the potential to improve PDAC outcomes.…”
Section: Introductionmentioning
confidence: 99%
“…The present study is the first nation-wide epidemiologic cohort of patients with resected CRC where the impact of ATBs intake on recurrence has been investigated. To evaluate the link between anti-cancer drug efficacy and ATB consumption, previous studies looked at an ATBs intake 1 to 3 months before anti-cancer drug administration 15,16 . In our study, an extensive perioperative period with a range of 6 months before to 1 year after surgery was considered with the rational that ATBs can disturb gut microbiota for more than several months 17 .…”
Section: Discussionmentioning
confidence: 99%