The association between antibiotic use and survival in renal cell carcinoma patients treated with immunotherapy: a multi-center study

Güven, Deniz Can; Acar, Ramazan; Yekedüz, Emre; Bilgetekin, İrem; Baytemür, Naziyet Köse; Erol, Cihan; Ceylan, Furkan; Şendur, Mehmet Ali Nahit; Demırcı, Umut; Ürün, Yüksel; Karadurmuş, Nuri; Erman, Mustafa; Kılıçkap, Saadettin

doi:10.1016/j.currproblcancer.2021.100760

Cited by 15 publications

(11 citation statements)

References 28 publications

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“…Cumulative meta-analysis ( Supplementary Figure 1 ), studies before 2020 showed no heterogeneity (I 2 = 0%), and heterogeneity directly increased to I 2 = 64% after the inclusion of Derosa et al, 2021 ( 23 ). The heterogeneity did not change much following the addition of the next two studies [Guven et al, 2021 ( 34 ) and Taigo Kato et al, 2022 ( 22 )].…”

Section: Resultsmentioning

confidence: 94%

“…Fifty-eight records with topic on RCC, ATB and immunotherapy were fully reviewed. Ten studies ( 8 , 14 , 15 , 21 – 23 , 31 – 34 ) were included in the systematic review, four studies ( 8 , 14 , 15 , 31 ) were excluded from meta-analysis for the following reasons:…”

Section: Resultsmentioning

confidence: 99%

“…Totally, six studies ( 21 – 23 , 32 – 34 ) were included for meta-analysis, with five publications and one abstract enrolling 1,104 patients for PFS, 1,073 patients for OS, 934 patients for ORR, and 788 patients for PD. A flowchart of the literature search is shown in Figure 1 .…”

Section: Resultsmentioning

confidence: 99%

“…Only two studies, Derosa et al, 2018 ( 8 ) and Derosa et al, 2020 ( 15 ), carefully reported the reasons for using ATB, among which urinary tract infection was the main indication, followed by flu-like syndrome, mTOR inhibitor-associated events and perioperative use. For ATB types, β-lactam ± inhibitors were used most frequently, followed by quinolones (However, in Guven et al, 2021 ( 34 ), quinolones were the most frequently used antibiotics, accounted for 48.4%). Only Kulkarni et al, 2020 ( 33 ) reported the influence of antibiotic type on the clinical effect of ICIs treatment.…”

Section: Resultsmentioning

confidence: 99%

“…HR for OS was extracted from five studies ( 21 – 23 , 33 , 34 ) for meta-analysis, and one study was assessed using Kaplan–Meier curves. As shown in ( Figure 3 ), using the common effect model (I 2 = 25%, P=0.25), ATB exposure showed a significantly lower OS than no ATB exposure (pooled HR=1.69, 95%CI [1.34; 2.12]).…”

Section: Resultsmentioning

confidence: 99%

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

Luo

Hao

et al. 2022

Front. Immunol.

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BackgroundMicrobiome dysbiosis is considered a predictive biomarker of clinical response in renal cell carcinoma (RCC), which can be regulated by antibiotics (ATB). Multiple studies have shown that concomitant ATB administration has inhibitory effects on immunotherapy in RCC. This review aimed to assess the impact of ATB on patient survival and tumor response in RCC with immunotherapy.MethodsLiterature evaluating the effect of ATB on immunotherapy in RCC from Cochrane Library®, PubMed®, Embase®, Scopus®, and Web of Science® were systematically searched. Hazard ratios (HR) for progression-free survival (PFS) and overall survival (OS), odds ratio (OR) for objective response rate (ORR) and primary progressive disease (PD) were pooled as effect sizes for clinical outcomes. Subgroup analysis was conducted to reveal the determinants of the effect of ATB on immunotherapy, including time windows of ATB exposure to immunotherapy initiation, ICIs treatment and study location. The leave-one-out approach was adopted to analyze the heterogeneity formulated. Cumulative meta-analysis adding by time was used to observe dynamic changes of the results.ResultsTen studies were included in the systematic review and six studies (with n=1,104 patients) were included in the meta-analysis, four studies were excluded for overlapping patients with subsequent larger studies and lack of unique patient-level data. ATB administration was significantly correlated with shorter PFS (HR=2.10, 95%CI [1.54; 2.85], I2 = 2% after omitting study Derosa et al, 2021 detected by leave-one-out approach), shorter OS (HR=1.69, 95%CI [1.34; 2.12], I2 = 25%) and worse ORR (OR=0.58, 95%CI [0.41; 0.84]), but no difference was observed in risk of PD (OR=1.18, 95%CI [0.97; 1.44]). No significant differences existed among the subgroups for determining the determinants of ATB inhibition.ConclusionsConcomitant ATB with immunotherapy was associated with worse PFS, OS and ORR in RCC. No publication bias was observed in this study.Systematic review registrationhttps://www.crd.york.ac.uk/PROSPERO/display_record.php?RecordID=349577, identifier CRD42022349577.

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Section: Resultsmentioning

confidence: 94%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

See 3 more Smart Citations

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

Luo

Hao

et al. 2022

Front. Immunol.

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The gut microbiome, immune check point inhibition and immune-related adverse events in non-small cell lung cancer

Bredin¹,

Naidoo

2022

Cancer Metastasis Rev

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Systemic treatment options for patients with lung cancer have expanded in recent years, with a number of immunotherapeutic strategies now in our treatment armamentarium. Toxicity of and resistance to treatment hold a major stake in lung cancer morbidity and mortality. Herein, we summarise the background, current evidence and potential mechanisms underlying the role of the commensal gut microbiota in immunotherapy outcomes such as response and toxicity in patients with non-small cell lung cancer (NSCLC).

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Effect of liver metastasis on the efficacy of immune checkpoint inhibitors in cancer patients: a systemic review and meta-analysis

Tian

Han

Wang

et al. 2023

Clin Exp Metastasis

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The association between antibiotic use and survival in renal cell carcinoma patients treated with immunotherapy: a multi-center study

Cited by 15 publications

References 28 publications

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

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

The gut microbiome, immune check point inhibition and immune-related adverse events in non-small cell lung cancer

Effect of liver metastasis on the efficacy of immune checkpoint inhibitors in cancer patients: a systemic review and meta-analysis

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