Real world experience with pembrolizumab and nivolumab for treatment of non-small cell lung cancer (NSCLC) in an Irish Regional Cancer Center.

Dennehy, Colum; Mullally, William J.; Goggin, Caitríona; Gleeson, Jack Patrick; Greene, John; Power, Derek G.; O’Reilly, Seamus; Collins, Dearbhaile Catherine; O’Mahony, Deirdre; Bambury, Richard

doi:10.1200/jco.2018.36.15_suppl.e21196

Cited by 4 publications

(1 citation statement)

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“…Seven studies were excluded from the meta-analysis because they provided insufficient information (only median survival in months and not HR, or only qualitative information) to extract data on any of the four outcomes (Dennehy et al, 2018;Greally et al, 2018;Hemadri et al, 2019;Jun et al, 2020;Metges et al, 2018;Resteghini et al, 2019;Riudavets et al, 2019). Forty-one studies were included in the meta-analysis (Abu-Sbeih et al, 2019;Agarwal et al, 2019;Ahmed et al, 2018;Bagley et al, 2019;Barron et al, 2019;Chalabi et al, 2020;Derosa et al, 2018;Do et al, 2018;Elkrief et al, 2019;Facchinetti et al, 2020;Forde et al, 2020;Galli et al, 2019;Guo et al, 2019;Hakozaki et al, 2019;Hogue et al, 2019;Huemer et al, 2019;Iglesias-Santamaria, 2020;Kaderbhai et al, 2017;Kapoor et al, 2020;Kapoor et al, 2019;Khan et al, 2019;Kim et al, 2019;Kulkarni et al, 2019;Lalani et al, 2020;Masini et al, 2019;Mielgo Rubio et al, 2019;Mohiuddin et al, 2021;Ouaknine Krief et al, 2019;Pinato et al, 2019;Rounis et al, 2019;Routy et al, 2018;Schett et al, 2020;…”

Section: Meta-analysismentioning

confidence: 99%

Use of antibiotics is associated with worse clinical outcomes in patients with cancer treated with immune checkpoint inhibitors: A systematic review and meta-analysis

Tsikala‐Vafea

Belani

Vieira

et al. 2021

International Journal of Infectious Diseases

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Observational and experimental studies suggest that the use of antibiotics close to administration of immune checkpoint inhibitors (ICI) can have a negative effect on tumour response and patient survival, due to microbiome dysbiosis and the resultant suppression of host immune response against neoplastic cells. Methods: A systematic search of PUBMED and EMBASE was undertaken for studies published between 1 January 2017 and 1 June 2020, evaluating the association between the use of antibiotics and clinical outcomes in patients with cancer treated with ICIs. A meta-analysis of the association between the use of antibiotics and clinical outcomes was also performed. Results: Forty-eight studies met the inclusion criteria (12,794 patients). Use of antibiotics was associated with shorter overall survival [hazard ratio (HR) 1.88, 95% confidence interval (CI) 1.59-2.22; adjusted HR 1.87, 95% CI 1.55-2.25] and progression-free survival (HR 1.52, 95% CI 1.36-1.70; adjusted HR 1.93, 95% CI 1.59-2.36), decreased response rate [odds ratio (OR) 0.54, 95% CI 0.34-0.86] and more disease progression (OR 2.00, 95% CI 1.27-3.14). The negative association between the use of antibiotics and progression-free survival was stronger in patients with renal cell carcinoma or melanoma compared with lung cancer. Only antibiotic administration >1 month prior to ICI initiation was associated with increased disease progression. Heterogeneity was substantial for all outcomes. Conclusions: Recent use of antibiotics in patients with cancer treated with ICIs was associated with worse clinical outcomes. Such patients may benefit from dedicated antimicrobial stewardship programmes.

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Section: Meta-analysismentioning

confidence: 99%

Use of antibiotics is associated with worse clinical outcomes in patients with cancer treated with immune checkpoint inhibitors: A systematic review and meta-analysis

Tsikala‐Vafea

Belani

Vieira

et al. 2021

International Journal of Infectious Diseases

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Effects of Antibiotic Use on Outcomes in Cancer Patients Treated Using Immune Checkpoint Inhibitors: A Systematic Review and Meta-Analysis

Zheng

Gao

et al. 2020

Journal of Immunotherapy

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Antibiotic (ATB) use seems to negatively affect the outcomes of immune checkpoint inhibitors (ICIs). The aim of this review is to clarify whether ATB use influences the efficacy of ICI treatment in cancer patients. Databases of MEDLINE, Embase, and Cochrane Library were searched for reports published in English between January 2007 and December 2019. We included studies that compared the outcomes of ATB use and no-ATB use in cancer patients using ICIs. Two reviewers independently selected eligible studies and extracted the data. Meta-analysis was performed with pooling of unadjusted hazard ratios (HRs) for overall survival (OS) and progression-free survival (PFS), and with pooling of odds ratios (ORs) for objective response rate (ORR). Thirty-eight studies involving 8409 patients were finally included for qualitative or quantitative analyses. Cancer types included renal cell carcinoma, non–small cell lung cancer, urothelial carcinoma, melanoma, gastrointestinal cancer, and others. Meta-analyses revealed that ATB use was associated with poor OS [HR: 1.80, 95% confidence interval (CI): 1.44–2.26, P<0.001], PFS (HR: 1.55, 95% CI: 1.26–1.91, P<0.001) and ORR (OR: 0.63, 95% CI: 0.42–0.95, P=0.03). Subgroup analysis found that these relationships were not influenced by cancer type or ICI regimens, but were dependent on the timing of ATB use. Narrative results of multivariable analyses further confirmed the negative effects of ATB use on OS and PFS. In cancer patients using ICIs, pre-ATB use close to the start of ICI treatment (within 60 d) was detrimental to outcomes in terms of OS, PFS, and ORR.

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Comparative and combined effectiveness of innovative therapies in cancer: a literature review

et al. 2019

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To achieve therapeutic innovation in oncology, already expensive novel medicines are often concomitantly combined to potentially enhance effectiveness. While this aggravates the pricing problem, comparing effectiveness of novel yet expensive (concomitant) treatments is much needed for healthcare decisionmaking to deliver effective but affordable treatments. This study reviewed published clinical trials and real-world studies of targeted and immune therapies. In total, 48 studies compared and/or combined multiple novel products on breast, colorectal, lung and melanoma cancers. To a great extent, products evaluated in each study were owned by one manufacturer. However, cross-manufacturer assessments are also needed. Next to costs and intensive market competition, the absence of a regulatory framework enforcing real-world multiproduct studies prevents these from being conducted. Trusted third parties could facilitate such real-world studies, for which appropriate and efficient data access is needed.

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Real world experience with pembrolizumab and nivolumab for treatment of non-small cell lung cancer (NSCLC) in an Irish Regional Cancer Center.

Cited by 4 publications

References 0 publications

Use of antibiotics is associated with worse clinical outcomes in patients with cancer treated with immune checkpoint inhibitors: A systematic review and meta-analysis

Use of antibiotics is associated with worse clinical outcomes in patients with cancer treated with immune checkpoint inhibitors: A systematic review and meta-analysis

Effects of Antibiotic Use on Outcomes in Cancer Patients Treated Using Immune Checkpoint Inhibitors: A Systematic Review and Meta-Analysis

Comparative and combined effectiveness of innovative therapies in cancer: a literature review

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