Cancerworld Magazine
  • About the Magazine
    • About us
    • Editorial Team
    • Events
    • Archive
    • Contacts
  • Articles
    • Policy
    • Practice Points
    • Delivery of Care
    • Biology basic
    • Medicine
    • Featured
  • Contents
    • News
    • Editorials
    • Interviews to the Expert
    • In the Hot Seat
    • Profiles
    • Obituaries
    • Voices
  • ESO College Corner
SUBSCRIBE FOR FREE
Facebook
Twitter
LinkedIn
Cancerworld Magazine
Cancerworld Magazine
  • About the Magazine
    • About us
    • Editorial Team
    • Events
    • Archive
    • Contacts
  • Articles
    • Policy
    • Practice Points
    • Delivery of Care
    • Biology basic
    • Medicine
    • Featured
  • Contents
    • News
    • Editorials
    • Interviews to the Expert
    • In the Hot Seat
    • Profiles
    • Obituaries
    • Voices
  • ESO College Corner
Cancerworld Magazine > News > No reason to delay cancer immunotherapy following antibiotic use
  • News

No reason to delay cancer immunotherapy following antibiotic use

  • 15 March 2022
  • Janet Fricker
No reason to delay cancer immunotherapy following antibiotic use
Total
0
Shares
0
0
0
0
0

Exposure to antibiotics prior to anti-PD-1 antibody treatment had no effect on melanoma outcomes.  The French study, reported in the Journal of the National Cancer Institute (published March 7, 2022), found using antibiotics in a large cohort of advanced melanoma patients had no effect on overall survival (OS) or time-to-treatment discontinuation (TTD). “Physicians should not delay immunotherapy for patients who have recently received antibiotics,” conclude the authors, led by Alain Dupuy from University of Rennes, France.

Previously several observational studies have reported decreased response to immune checkpoint inhibitors (ICI) following antibiotics use. In keeping with this hypothesis, antibiotic treatment might reduce ICI efficacy through alterations in gut microbiota composition and diversity. However, relevant confounders could not be appropriately taken into consideration due to small sample sizes and heterogeneity. “For example, patients with certain comorbidities or locations of metastases could be more likely to receive antibiotics, and these data were absent or incomplete,” write Dupuy and his team.

In the current study, Dupuy and colleagues explored the impact of antibiotic exposure in a cohort of advanced melanoma patients receiving an anti-PD-1 antibody first-line between 2015 and 2017. Investigators used data prospectively collected in the French National Health Insurance database (SNDS, Systéme National des Données de Santé), containing information on all health-related expenditure, dates drugs were prescribed and diagnoses according to ICD-10 codes. The team compared OS and TTD according to antibiotic exposure in the three months prior to initiation of anti-PD-1 antibody. The team also evaluated a control cohort of patients with advanced melanoma receiving first-line targeted therapy, since there is no rationale for any decrease in efficacy of targeted therapy following antibiotic treatment.

To disentangle a causal effect of antibiotics from a confounding bias, the team balanced characteristics of patients exposed and not-exposed to antibiotics using an overlap weighting method based on a propensity score. The multivariate logistic regression analysis took into consideration covariates including age, sex, number and location of metastatic sites, previous surgery, and stereotactic or external beam radiotherapy. In addition, numerous comorbidities were explored including cardiovascular or cerebrovascular disorders, diabetes, history of another cancer, chronic respiratory, renal, liver or pancreatic disease etc.

Results showed altogether there were 2605 patients in the anti-PD-1 antibody cohort, of whom 749 (28.6%) received antibiotics in the three months prior to anti-PD-1 initiation. In the targeted therapy cohort there were 1527 patients, of whom 460 (30.1%) received antibiotics in the three months prior to anti-PD-1 initiation.

In the anti-PD-1 antibody cohort, 956 (36.7%) of patients had died and 1602 (61.5%) had discontinued their first treatment line by 31 December 2017. Antibiotic exposure was not associated with shorter OS (wHR=1.01) or TTD (wHR=1.00).

In the targeted therapy cohort, 701 (45.9%) patients had died and 1074 (70.3%) had discontinued their first treatment line by 31 December, 2017. Antibiotic exposure was not associated with OS (wHR=1.08) or TTD (wHR=1.04).

Consistent results were observed when the timeframe for antibiotic exposure was reduced to one month prior to anti-PD-1 initiation, or when exposure was limited to antibiotics causing more profound gut dysbiosis.

“Unlike previous findings, we show that antibiotic treatment before anti-PD-1 antibody initiation is not associated with decreased efficacy of anti-PD-1 antibody among metastatic melanoma patients,” write the authors. “While some may consider that the jury is still out, we argue that strong and reasonable doubt exists for confounding by indication as the culprit accounting for a so-called antibiotic-induced detrimental effect on ICI efficacy.”

Avoiding delaying immunotherapy, they add, represents a widely-shared attitude in metastatic settings that should also be adopted when administering ICI in adjuvant settings.

Total
0
Shares
Share 0
Tweet 0
Share 0
Share 0
Share 0
Related Topics
  • anti-PD-1 antibody
  • antibiotics
  • gut microbiome
  • immune checkpoint inhibitors
  • Systéme National des Données de Santé
Janet Fricker

Janet Fricker is a medical writer specialising in oncology and cardiology. After researching articles for Cancerworld she runs, swims, and eats porridge.

Previous Article
  • Articles
  • Policy

The invisible cure. Should we be talking more about cancer surgery?

  • 10 March 2022
  • Anna Wagstaff
View Post
Next Article
  • News

European Cancer Community urged to sign-up to help Ukrainian patients

  • 15 March 2022
  • Janet Fricker
View Post
You May Also Like
View Post
  • News

How a Brain-Destroying Protein Became Cancer’s Ally: Alpha-Synuclein Emerges as a New Target in Melanoma

  • Janet Fricker
  • 4 July 2025
View Post
  • News

CancerWorld #105 (July 2025)

  • Yeva Margaryan
  • 2 July 2025
View Post
  • News

How a Chicken Egg Model Could Transform Pediatric Cancer Treatment in Canada

  • Victoria Forster
  • 20 June 2025
View Post
  • News

Microbiota-Derived Bile Acids as Androgen Receptor Antagonists Enhance Anti-Tumour Immunity

  • Janet Fricker
  • 19 June 2025
View Post
  • Articles
  • News

Strategies Needed to Prioritise Screening in Survivors of Childhood Cancer

  • Janet Fricker
  • 4 June 2025
View Post
  • Articles
  • News

CancerWorld #104 (June 2025)

  • Yeva Margaryan
  • 2 June 2025
View Post
  • Articles
  • Medicine
  • News

Common Diabetes Medication Could Protect Heart Health During Cancer Treatment

  • Janet Fricker
  • 30 May 2025
View Post
  • Articles
  • News

CancerWorld issue #103 (May, 2025)

  • Yeva Margaryan
  • 11 May 2025
search
CancerWorld #105 Download CancerWorld #104 Download CancerWorld #103 Download CancerWorld #102 Download CancerWorld #101 Download or search in Cancerworld archive
Newsletter

Subscribe free to
Cancerworld!

We'll keep you informed of the latest features and news with a fortnightly email

Subscribe now
Latest News
  • How a Brain-Destroying Protein Became Cancer’s Ally: Alpha-Synuclein Emerges as a New Target in Melanoma
    • 4 July 2025
  • CancerWorld #105 (July 2025)
    • 2 July 2025
  • How a Chicken Egg Model Could Transform Pediatric Cancer Treatment in Canada
    • 20 June 2025
  • Microbiota-Derived Bile Acids as Androgen Receptor Antagonists Enhance Anti-Tumour Immunity
    • 19 June 2025
  • Strategies Needed to Prioritise Screening in Survivors of Childhood Cancer
    • 4 June 2025
Article
  • Suheir Rasul: Protecting Human Dignity
    • 4 July 2025
  • Equity:The Word That Shaped Her Career From The Lab To The White House:The Story Of Catharine Young
    • 4 July 2025
  • Curious, Rejected,Accepted: An ESO Fellow’s Road to Becoming an Oncologist
    • 3 July 2025
Social

Would you follow us ?

Contents
  • Suheir Rasul: Protecting Human Dignity
    • 4 July 2025
  • Equity:The Word That Shaped Her Career From The Lab To The White House:The Story Of Catharine Young
    • 4 July 2025
  • Curious, Rejected,Accepted: An ESO Fellow’s Road to Becoming an Oncologist
    • 3 July 2025
MENU
  • About the Magazine
    • About us
    • Editorial Team
    • Events
    • Archive
    • Contacts
  • Articles
    • Policy
    • Practice Points
    • Delivery of Care
    • Biology basic
    • Medicine
    • Featured
  • Contents
    • News
    • Editorials
    • Interviews to the Expert
    • In the Hot Seat
    • Profiles
    • Obituaries
    • Voices
  • ESO College Corner
Cancerworld Magazine
  • About us
  • Articles
  • Media Corner
  • Privacy Policy
  • Cookie Policy

Cancerworld is published by OncoDaily (P53 Inc.) | Mailing Address: 867 Boylston st, 5th floor, Ste 1094 Boston, MA 02116, United States | [email protected]

Archivio Cancerworld

Input your search keywords and press Enter.