Use of Antibiotics during Immune Checkpoint Inhibitor Treatment Is Associated with Lower Survival in Hepatocellular Carcinoma

Cheung, Ka Shing; Lam, Lok Ka; Seto, Wai Kay; Leung, Wai Keung

doi:10.1159/000518090

Cited by 41 publications

(40 citation statements)

References 29 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Studies retrieved and characteristics 467 eligible records were screened for their titles and abstracts to check for their eligibility. After a detailed analysis of 14 full-text records, we found that six studies met the inclusion criteria (17,18,(20)(21)(22)(23). The articles by Ren et al (24) and Jun et al (25) were excluded from the meta-analysis due to insufficient data and duplicate publication, respectively.…”

Section: Resultsmentioning

confidence: 99%

The association between antibiotic use and outcomes of HCC patients treated with immune checkpoint inhibitors

et al. 2022

View full text Add to dashboard Cite

ObjectiveRecently, immune checkpoint inhibitor (ICI) treatment has shown encouraging performance in improving the prognosis of hepatocellular carcinoma (HCC) patients. The gut microbiome plays a vital role in altering the efficacy of ICIs, which may be impacted by antibiotics. The aim of the meta-analysis is to estimate the influence of antibiotic use on the survival of HCC patients treated with ICIs.MethodsThe literature review was conducted using databases like PubMed, EMBASE, Cochrane Library, CNKI, WANFANG DATA, VIP, Google Scholar, and ClinicalTrials.gov before May 15, 2022. The primary endpoints were overall survival (OS), progression-free survival (PFS), objective response rate (ORR), and disease control rate (DCR).ResultsA total of six retrospective studies met the inclusion criteria. 1056 patients were included in the study, of which 352 (33.33%) received antibiotic treatment. The meta-analysis results revealed antibiotic use did not affect the OS (HR: 1.41, 95% CI: 0.96-2.08, P = 0.088) and PFS (HR: 1.21, 95% CI: 0.73-2.00, P = 0.459) in HCC patients treated with ICIs. Besides, the use of antibiotics did not reduce the ORR (OR: 1.06, 95% CI: 0.69-1.64, P = 0.784) and DCR (OR: 0.42, 95% CI: 0.09-2.06, P = 0.286) in HCC patients treated with ICIs.ConclusionCurrent evidence reveals that antibiotic use does alter the therapeutic efficacy of ICIs in HCC patients.Systematic Review Registrationhttps://www.crd.york.ac.uk/, identifier CRD42022311948.

show abstract

Section: Resultsmentioning

confidence: 99%

The association between antibiotic use and outcomes of HCC patients treated with immune checkpoint inhibitors

et al. 2022

View full text Add to dashboard Cite

show abstract

“…One of the limitations of the current study is the definition of antibiotic use, including the duration of exposure and the time interval between last antibiotic use and vaccination. We used an arbitrary cutoff of ever use of any antibiotics within six months before vaccination [ 21 ], as antibiotic-induced gut microbiota perturbation took at least six months to recover [ 9 ]. Due to the relatively small number of antibiotic users ( n = 29), any stratified analysis according to duration of antibiotic use and the time interval from last antibiotic use will likely suffer from underpower.…”

Section: Discussionmentioning

confidence: 99%

“…Exposure of interest was pre-vaccination antibiotic use, defined as ever use of any antibiotics within six months before vaccination [ 21 ]. The six-month cut-off was used because antibiotic-induced gut microbiota perturbation took months to recover [ 9 ].…”

Section: Exposure Of Interest and Covariatesmentioning

confidence: 99%

Association between Recent Usage of Antibiotics and Immunogenicity within Six Months after COVID-19 Vaccination

et al. 2022

Self Cite

View full text Add to dashboard Cite

Background: Gut microbiota can be associated with COVID-19 vaccine immunogenicity. We investigated whether recent antibiotic use influences BNT162b2 vaccine immunogenicity. Methods: BNT162b2 recipients from three centers were prospectively recruited. Outcomes of interest were seroconversion of neutralising antibody (NAb) at day 21, 56 and 180 after first dose. We calculated the adjusted odds ratio (aOR) of seroconversion with antibiotic usage (defined as ever use of any antibiotics within six months before first dose of vaccine) by adjusting for covariates including age, sex, smoking, alcohol, and comorbidities. Results: Of 316 BNT162b2 recipients (100 [31.6%] male; median age: 50.1 [IQR: 40.0–57.0] years) recruited, 29 (9.2%) were antibiotic users. There was a trend of lower seroconversion rates in antibiotic users than non-users at day 21 (82.8% vs. 91.3%; p = 0.14) and day 56 (96.6% vs. 99.3%; p = 0.15), but not at day 180 (93.3% vs. 94.1%). A multivariate analysis showed that recent antibiotic usage was associated with a lower seroconversion rate at day 21 (aOR 0.26;95% CI: 0.08–0.96). Other factors associated with a lower seroconversion rate after first dose of the BNT162b2 vaccine included age ≥ 60 years (aOR: 0.34;95% CI: 0.13–0.95) and male sex (aOR: 0.14, 95% CI: 0.05–0.34). There were no significant factors associated with seroconversion after two doses of BNT16b2, including antibiotic use (aOR: 0.03;95% CI: 0.001–1.15). Conclusions: Recent antibiotic use may be associated with a lower seroconversion rate at day 21 (but not day 56 or 180) among BNT162b2 recipients. Further long-term follow-up data with a larger sample size is needed to reach a definite conclusion on how antibiotics influence immunogenicity and the durability of the vaccine response.

show abstract

“…The humanized monoclonal antibodies target inhibitory receptors to provoke an antitumor immune response and modulate T-cell activation by interrupting the delivery of inhibitory signals ( 73 ). A retrospective cohort study investigated the impacts of antibiotics on the clinical trial results of ICIs for treating patients with HCC ( 74 ). Antibiotics against anaerobes were linked with a higher risk of HCC-related death during ICI therapy when compared with antibiotics against aerobes.…”

Section: Antibiotics In Hccmentioning

confidence: 99%

Utilizing Gut Microbiota to Improve Hepatobiliary Tumor Treatments: Recent Advances

Qin

Yuan²,

Huang³

et al. 2022

Front. Oncol.

View full text Add to dashboard Cite

Hepatobiliary tumors, which include cholangiocarcinoma, hepatocellular carcinoma (HCC), and gallbladder cancer, are common cancers that have high morbidity and mortality rates and poor survival outcomes. In humans, the microbiota is comprised of symbiotic microbial cells (10-100 trillion) that belong to the bacterial ecosystem mainly residing in the gut. The gut microbiota is a complicated group that can largely be found in the intestine and has a dual role in cancer occurrence and progression. Previous research has focused on the crucial functions of the intestinal microflora as the main pathophysiological mechanism in HCC development. Intestinal bacteria produce a broad range of metabolites that exhibit a variety of pro- and anticarcinogenic effects on HCC. Therefore, probiotic alteration of the gut microflora could promote gut flora balance and help prevent the occurrence of HCC. Recent evidence from clinical and translational studies suggests that fecal microbiota transplant is one of the most successful therapies to correct intestinal bacterial imbalance. We review the literature describing the effects and mechanisms of the microbiome in the gut in the context of HCC, including gut bacterial metabolites, probiotics, antibiotics, and the transplantation of fecal microbiota, and discuss the potential influence of the microbiome environment on cholangiocarcinoma and gallbladder cancer. Our findings are expected to reveal therapeutic targets for the prevention of hepatobiliary tumors, and the development of clinical treatment strategies, by emphasizing the function of the gut microbiota.

show abstract

Use of Antibiotics during Immune Checkpoint Inhibitor Treatment Is Associated with Lower Survival in Hepatocellular Carcinoma

Cited by 41 publications

References 29 publications

The association between antibiotic use and outcomes of HCC patients treated with immune checkpoint inhibitors

The association between antibiotic use and outcomes of HCC patients treated with immune checkpoint inhibitors

Association between Recent Usage of Antibiotics and Immunogenicity within Six Months after COVID-19 Vaccination

Utilizing Gut Microbiota to Improve Hepatobiliary Tumor Treatments: Recent Advances

Contact Info

Product

Resources

About