The negative effect of antibiotics on RCC patients with immunotherapy: A systematic review and meta-analysis

Luo, Zhiqiang; Hao, Siyuan; Li, Yuxuan; Cheng, Lei; Gunes, Emine Gulsen; Liu, Shiyu; Chen, Jing

doi:10.3389/fimmu.2022.1065004

Cited by 8 publications

(3 citation statements)

References 47 publications

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“…Table 1 summarizes the basic characteristics of the 23 included publications (10)(11)(12)(25)(26)(27)(28)(29)(30)(31)(32)(33)(34)(35)(36)(37)(38)(39)(40)(41)(42)(43)(44). These publications were from China (n=19), the United States of America (n=2), Australia (n=1), and France (n=1).…”

Section: Basic Characteristicsmentioning

confidence: 99%

Impact of concomitant medications on the efficacy of immune checkpoint inhibitors: an umbrella review

Li,

Zhang,

Yang

et al. 2023

Front. Immunol.

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IntroductionCancer is a major global health concern, and immune checkpoint inhibitors (ICIs) offer a promising treatment option for cancer patients. However, the efficacy of ICIs can be influenced by various factors, including the use of concomitant medications.MethodsWe searched databases (PubMed, Embase, Cochrane Library, Web of Science) for systematic reviews and meta-analyses for systematic reviews and meta-analyses on the impact of concomitant medications on ICIs efficacy, published from inception to January 1, 2023. We evaluated the methodological quality of the included meta-analyses, and re-synthesized data using a random-effects model and evidence stratification.ResultsWe included 23 publications, comprising 11 concomitant medications and 112 associations. Class II-IV evidence suggested that antibiotics have a negative impact on ICIs efficacy. However, ICIs efficacy against melanoma, hepatocellular carcinoma, and esophageal squamous cell carcinoma was not affected, this effect was related to the exposure window (class IV). Class III evidence suggested that proton pump inhibitors have a negative impact on ICIs efficacy; nevertheless, the efficacy against melanoma and renal cell carcinoma was not affected, and the effect was related to exposure before the initiation of ICIs therapy (class II). Although class II/III evidence suggested that steroids have a negative impact, this effect was not observed when used for non-cancer indications and immune-related adverse events (class IV). Class IV evidence suggested that opioids reduce ICIs efficacy, whereas statins and probiotics may improve ICIs efficacy. ICIs efficacy was not affected by histamine 2 receptor antagonists, aspirin, metformin, β-blockers, and nonsteroidal anti-inflammatory agents.ConclusionCurrent evidence suggests that the use of antibiotics, PPIs, steroids, and opioids has a negative impact on the efficacy of ICIs. However, this effect may vary depending on the type of tumor, the timing of exposure, and the intended application. Weak evidence suggests that statins and probiotics may enhance the efficacy of ICIs. Aspirin, metformin, β-blockers, and NSAIDs do not appear to affect the efficacy of ICIs. However, caution is advised in interpreting these results due to methodological limitations.Systematic review registrationhttps://www.crd.york.ac.uk/PROSPERO,identifier, CRD42022328681.

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Section: Basic Characteristicsmentioning

confidence: 99%

Impact of concomitant medications on the efficacy of immune checkpoint inhibitors: an umbrella review

Li,

Zhang,

Yang

et al. 2023

Front. Immunol.

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“…However, treatments with drugs such as amoxicillin/clavulanic acid or clindamycin resulted in major changes to all bacterial groups (Clostridium, Enterobacteriaceae, Bifidobacterium, and Bacteroides). Dysbiotic changes induced by antibiotics are generally temporary; nevertheless, in some cases, the consequences can transcend and predispose the individual to pathologies such as obesity, GI perturbations, or bacterial resistance [155][156][157].…”

Section: Age-related Microbiome Modificationsmentioning

confidence: 99%

Exploring the Relationship between the Gut Microbiota and Ageing: A Possible Age Modulator

Salazar

Durán

Díaz

et al. 2023

IJERPH

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The gut microbiota (GM) has been the subject of intense research in recent years. Therefore, numerous factors affecting its composition have been thoroughly examined, and with them, their function and role in the individual’s systems. The gut microbiota’s taxonomical composition dramatically impacts older adults’ health status. In this regard, it could either extend their life expectancy via the modulation of metabolic processes and the immune system or, in the case of dysbiosis, predispose them to age-related diseases, including bowel inflammatory and musculoskeletal diseases and metabolic and neurological disorders. In general, the microbiome of the elderly tends to present taxonomic and functional changes, which can function as a target to modulate the microbiota and improve the health of this population. The GM of centenarians is unique, with the faculty-promoting metabolic pathways capable of preventing and counteracting the different processes associated with age-related diseases. The molecular mechanisms by which the microbiota can exhibit anti-ageing properties are mainly based on anti-inflammatory and antioxidant actions. This review focuses on analysing the current knowledge of gut microbiota characteristics and modifiers, its relationship with ageing, and the GM-modulating approaches to increase life expectancy.

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“…It was recently reported that antibiotics can reduce the treatment efficacy of nivolumab in several types of cancers (lung cancer, renal cancer, and melanoma) [12‒15]. Head and neck SCC patients are often treated with antibiotics for various reasons, such as infection, myelosuppression due to chemotherapy, prevention of acne-like eruptions with anti-epidermal growth factor receptor antibody, and so on [16, 17].…”

Section: Introductionmentioning

confidence: 99%

Antibiotics May Interfere with Nivolumab Efficacy in Patients with Head and Neck Squamous Cell Carcinoma

Ueta,

Imai,

Saijo

et al. 2023

Oncology

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Introduction: Patients with the head and neck squamous cell carcinoma (SCC) are often treated with immune checkpoint inhibitors (ICIs). Recently, antibiotic intake was reported to lower the efficacy of ICIs in patients with several types of cancers. However, it is unclear if antibiotics affect the efficacy of ICIs in patients with head and neck SCC. We retrospectively assessed the influence of antibiotics on the treatment efficacy of nivolumab, an ICI, in patients with head and neck SCC. Methods: We reviewed the medical records of patients with head and neck SCC treated with nivolumab at the Department of Medical Oncology, Tohoku University Hospital, between 2017 and 2021. Patients who received oral or intravenous antibiotics from a month before the day of nivolumab initiation to the day of the first imaging evaluation of ICI efficacy were assigned to the antibiotic-treated group. The remaining patients were assigned to the antibiotic-untreated group. The response rate (RR), progression-free survival (PFS), and overall survival time (OS) of both groups were compared. Results: Forty-five patients were assigned to the antibiotic-treated group and 19 to the antibiotic-untreated group. The RR, median PFS, and median OS of the antibiotic-treated group were 23.7%, 3.2 months (95% confidential interval [CI]: 2.0–4.1), and 8.4 months (95% CI: 5.3–15.1) and those of the antibiotic-untreated group were 42.1%, 5.8 months (95% CI: 2.3–16.7), and 18.4 months (95% CI: 6.2–23.1), respectively. The PFS of the antibiotic-untreated group was significantly longer than that of the antibiotic-treated group. Conclusion: Our findings indicate that antibiotic treatment significantly shortens the PFS with nivolumab therapy in patients with head and neck SCC.

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The negative effect of antibiotics on RCC patients with immunotherapy: A systematic review and meta-analysis

Cited by 8 publications

References 47 publications

Impact of concomitant medications on the efficacy of immune checkpoint inhibitors: an umbrella review

Impact of concomitant medications on the efficacy of immune checkpoint inhibitors: an umbrella review

Exploring the Relationship between the Gut Microbiota and Ageing: A Possible Age Modulator

Antibiotics May Interfere with Nivolumab Efficacy in Patients with Head and Neck Squamous Cell Carcinoma

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