Impact of Antibiotics and Proton Pump Inhibitors on Efficacy and Tolerance of Anti-PD-1 Immune Checkpoint Inhibitors
| العنوان: | Impact of Antibiotics and Proton Pump Inhibitors on Efficacy and Tolerance of Anti-PD-1 Immune Checkpoint Inhibitors |
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| المؤلفون: | Julia Salleron, Catherine Vallance, Quentin Giordan, Christelle Clement-Duchene, Clothilde Moriana |
| المصدر: | Frontiers in Immunology, Vol 12 (2021) Frontiers in Immunology |
| بيانات النشر: | Frontiers Media S.A., 2021. |
| سنة النشر: | 2021 |
| مصطلحات موضوعية: | Adult, Male, medicine.medical_specialty, Lung Neoplasms, medicine.drug_class, Programmed Cell Death 1 Receptor, Immunology, Antibiotics, non-small cell lung cancer (NSCLC), Gastroenterology, antibiotics, immune checkpoint inhibitors (ICI), non-small-cell lung carcinoma (NSCLC), renal cell carcinoma (RCC), Renal cell carcinoma, Carcinoma, Non-Small-Cell Lung, Internal medicine, medicine, Carcinoma, melanoma, Humans, Immunology and Allergy, Drug Interactions, Adverse effect, Immune Checkpoint Inhibitors, Original Research, Aged, Neoplasm Staging, Retrospective Studies, business.industry, Hazard ratio, Cancer, Proton Pump Inhibitors, Common Terminology Criteria for Adverse Events, Middle Aged, RC581-607, Prognosis, medicine.disease, Anti-Bacterial Agents, Treatment Outcome, Female, head and neck cancer, Neoplasm Grading, Immunologic diseases. Allergy, proton-pump inhibitor (PPI), business |
| الوصف: | BackgroundThe use of antibiotics (ATB) and proton-pump inhibitors (PPI) alters the composition and diversity of the gut microbiota, which can influence the immune system, consequently interfering with response to anti-PD1 immune checkpoint inhibitors (ICI). We assessed the impact of ATB and/or PPI use on the efficacy and safety of ICI.MethodsTwo hundred twelve patients treated with anti-PD1 ICI for non-small cell lung carcinoma, melanoma, upper airway & digestive tract carcinoma or renal cell carcinoma were retrospectively included. Patients having received ATB within 60 days before ICI initiation were included in the ATB+ group. Patients having received PPI within 30 days before ICI initiation were included in the PPI+ group. Four groups were thus considered: ATB-/PPI-, ATB+/PPI-, ATB-/PPI+, ATB+/PPI+. Response rate was assessed by RECIST v1.1. Overall survival (OS), progression-free survival (PFS) and adverse events, recorded using Common Terminology Criteria for Adverse Events Version 5, were compared using inverse probability of treatment weighting to account for selection bias.ResultsPFS at 6 months was 56.7 %, 95%CI (49.6%; 63.2%) and 47.2 %, 95%CI (39.8%;54.1%) at 12 months. OS was 81.6%, 95%CI (75.6%; 86.2%) at 6 months, and 69.4%, 95%CI (61.9%;75.7%) at 12 months. Compared to ATB-/PPI- group, PFS was lower for the ATB+/PPI- group [Hazard ratio (HR) 1.90, 95%CI (1.41;2.57)] and the ATB-/PPI+ group [HR 1.51, 95%CI (1.11;2.05)], and lowest in the ATB+/PPI+ group [HR 3.65, 95%CI (2.75;4.84)]. For OS, the use of ATB alone or PPI alone or in combination was a risk factor for death, with each increasing HR values by a similar magnitude, and the combination of ATB and PPI did not increase risk further. AEs were observed in 78 cases (36.8%) with no significant impact of ATB or PPI use.ConclusionsThis study reveals that ATB and/or PPI use can alter response to anti-PD1 ICI, and the prognosis of cancer patients. The microbiota mechanisms involved in the response to ICI should be investigated to optimize patient management. |
| اللغة: | English |
| تدمد: | 1664-3224 |
| الوصول الحر: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::2d5badc27b161fb1addeca98b1660f08Test https://www.frontiersin.org/articles/10.3389/fimmu.2021.716317/fullTest |
| حقوق: | OPEN |
| رقم الانضمام: | edsair.doi.dedup.....2d5badc27b161fb1addeca98b1660f08 |
| قاعدة البيانات: | OpenAIRE |
| تدمد: | 16643224 |
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