Effect of antimicrobial therapy on progression-free survival of patients with non-small cell lung cancer receiving checkpoint inhibitor- and chemotherapy

Uhlenbruch, Mark; Krüger, Stefan

doi:10.1007/s00432-021-03734-z

“…A gut dysbiosis due to antimicrobial therapy (AMT) is associated with a dysfunctional immune system 1,2 . In a retrospective study it was shown, that AMT, given within a month before CPI, leads to a shorter progression free survival (PFS) in patients with NSCLC 3 . Some studies showed negative effects of AMT on outcome in patients with chemotherapy, too.…”

Section: Introductionmentioning

confidence: 99%

Effect of antimicrobial therapy on progression-free survival of immunotherapy and chemo-/immunotherapy in patients with non-small cell lung cancer

Uhlenbruch

¹

,

Krüger

²

2023

J Cancer Res Clin Oncol

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Background: The choice between immunotherapy with a checkpoint inhibitor (CPI) and chemo-/immunotherapy (CIT) in patients with NSCLC stage IV is often discussed. There is some data that the effect of CPI-therapy is impaired by antimicrobial therapy (AMT). Little is known about the in uence of AMT on CIT.Patients and methods: We retrospectively analysed 114 patients (age 68 ± 8.5 y) with NSCLC stage IV.Patients were treated according to the guidelines with either CPI alone (pembrolizumab, nivolumab, atezolizumab, cemiplimab) or CIT (Carboplatin/Pemetrexed/Pembrolizumab, Carboplatin/Paclitaxel/Pembrolizumab). We registered patients' characteristics including presence and timing of AMT. Group 1 consisted of 42 patients with AMT in the month before CPI or CIT, group 2 were 49 patients with AMT during CPI or CIT, and group 3 were 64 patients without AMT and CPI or CIT.

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Effect of TTF-1 expression on progression free survival of immunotherapy and chemo-/immunotherapy in patients with non-small cell lung cancer

Uhlenbruch,

Krüger

2024

J Cancer Res Clin Oncol

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Effect of antimicrobial therapy on progression free survival of immunotherapy and chemo-/immunotherapy in patients with non-small cell lung cancer

Uhlenbruch

¹

,

Krüger

²

2022

Preprint

Self Cite

0

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Background: The choice between immunotherapy with a checkpoint inhibitor (CPI) and chemo-/immunotherapy (CIT) in patients with NSCLC stage IV is often discussed. There is some data that the effect of CPI-therapy is impaired by antimicrobial therapy (AMT). Little is known about the influence of AMT on CIT. Patients and methods: We retrospectively analysed 114 patients (age 68 ± 8.5 y) with NSCLC stage IV. Patients were treated according to the guidelines with either CPI alone (pembrolizumab, nivolumab, atezolizumab, cemiplimab) or CIT (Carboplatin/Pemetrexed/Pembrolizumab, Carboplatin/Paclitaxel/Pembrolizumab). We registered patients’ characteristics including presence and timing of AMT. Group 1 consisted of 42 patients with AMT in the month before CPI or CIT, group 2 were 49 patients with AMT during CPI or CIT, and group 3 were 64 patients without AMT and CPI or CIT. Results: Group 1-3 showed comparable patients characteristics. Using cox-regression analysis, we found that AMT in the month before CPI resulted in a decreased progression free survival (PFS) compared to patients with CPI and no AMT (14 ± 1.02 vs. 4 ± 1.02 months, p = 0.002, 95% CI: 1.88-9). In patients, who were treated with CIT, there was no difference in PFS in those with or without AMT in the month before therapy (10 ± 2.5 vs. 6 ± 1.2 months, p = 0.7). Interestingly, AMT during CIT or CPI therapy showed no effect on PFS. Conclusions: In a real-life setting, we found that AMT reduces PFS when given in the month before CIT therapy. AMT before or during CIT does not seem to influence PFS. As a consequence, AMT before start of therapy might be a factor that could lead to a preference of CIT instead of CPI in NSCLC stage IV patients

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Effect of antimicrobial therapy on progression-free survival of patients with non-small cell lung cancer receiving checkpoint inhibitor- and chemotherapy

Cited by 3 publications

References 5 publications

Effect of antimicrobial therapy on progression-free survival of immunotherapy and chemo-/immunotherapy in patients with non-small cell lung cancer

Effect of antimicrobial therapy on progression-free survival of immunotherapy and chemo-/immunotherapy in patients with non-small cell lung cancer

Effect of TTF-1 expression on progression free survival of immunotherapy and chemo-/immunotherapy in patients with non-small cell lung cancer

Effect of antimicrobial therapy on progression free survival of immunotherapy and chemo-/immunotherapy in patients with non-small cell lung cancer

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