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Survival of Patients Treated with Antibiotics and Immunotherapy for Cancer: A Systematic Review and Meta-Analysis

Antibiotics (ABs) are common medications used for treating infections. In cancer patients treated with immune checkpoint inhibitors (ICIs), concomitant exposure to ABs may impair the efficacy of ICIs and lead to a poorer outcome compared to AB non-users. We report here the results of a meta-analysis...

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Autores principales: Petrelli, Fausto, Iaculli, Alessandro, Signorelli, Diego, Ghidini, Antonio, Dottorini, Lorenzo, Perego, Gianluca, Ghidini, Michele, Zaniboni, Alberto, Gori, Stefania, Inno, Alessandro
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7290584/
https://www.ncbi.nlm.nih.gov/pubmed/32414103
http://dx.doi.org/10.3390/jcm9051458
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author Petrelli, Fausto
Iaculli, Alessandro
Signorelli, Diego
Ghidini, Antonio
Dottorini, Lorenzo
Perego, Gianluca
Ghidini, Michele
Zaniboni, Alberto
Gori, Stefania
Inno, Alessandro
author_facet Petrelli, Fausto
Iaculli, Alessandro
Signorelli, Diego
Ghidini, Antonio
Dottorini, Lorenzo
Perego, Gianluca
Ghidini, Michele
Zaniboni, Alberto
Gori, Stefania
Inno, Alessandro
author_sort Petrelli, Fausto
collection PubMed
description Antibiotics (ABs) are common medications used for treating infections. In cancer patients treated with immune checkpoint inhibitors (ICIs), concomitant exposure to ABs may impair the efficacy of ICIs and lead to a poorer outcome compared to AB non-users. We report here the results of a meta-analysis evaluating the effects of ABs on the outcome of patients with solid tumours treated with ICIs. PubMed, the Cochrane Library and Embase were searched from inception until September 2019 for observational or prospective studies reporting the prognoses of adult patients with cancer treated with ICIs and with or without ABs. Overall survival (OS) was the primary endpoint, and progression-free survival (PFS) was the secondary endpoint. The effect size was reported as hazard ratios (HRs) with a 95% confidence interval (CI) and an HR > 1 associated with a worse outcome in ABs users compared to AB non-users. Fifteen publications were retrieved for a total of 2363 patients. In the main analysis (n = 15 studies reporting data), OS was reduced in patients exposed to ABs before or during treatment with ICIs (HR = 2.07, 95%CI 1.51–2.84; p < 0.01). Similarly, PFS was inferior in AB users in n = 13 studies with data available (HR = 1.53, 95%CI 1.22–1.93; p < 0.01). In cancer patients treated with ICIs, AB use significantly reduced OS and PFS. Short duration/course of ABs may be considered in clinical situations in which they are strictly needed.
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spelling pubmed-72905842020-06-17 Survival of Patients Treated with Antibiotics and Immunotherapy for Cancer: A Systematic Review and Meta-Analysis Petrelli, Fausto Iaculli, Alessandro Signorelli, Diego Ghidini, Antonio Dottorini, Lorenzo Perego, Gianluca Ghidini, Michele Zaniboni, Alberto Gori, Stefania Inno, Alessandro J Clin Med Communication Antibiotics (ABs) are common medications used for treating infections. In cancer patients treated with immune checkpoint inhibitors (ICIs), concomitant exposure to ABs may impair the efficacy of ICIs and lead to a poorer outcome compared to AB non-users. We report here the results of a meta-analysis evaluating the effects of ABs on the outcome of patients with solid tumours treated with ICIs. PubMed, the Cochrane Library and Embase were searched from inception until September 2019 for observational or prospective studies reporting the prognoses of adult patients with cancer treated with ICIs and with or without ABs. Overall survival (OS) was the primary endpoint, and progression-free survival (PFS) was the secondary endpoint. The effect size was reported as hazard ratios (HRs) with a 95% confidence interval (CI) and an HR > 1 associated with a worse outcome in ABs users compared to AB non-users. Fifteen publications were retrieved for a total of 2363 patients. In the main analysis (n = 15 studies reporting data), OS was reduced in patients exposed to ABs before or during treatment with ICIs (HR = 2.07, 95%CI 1.51–2.84; p < 0.01). Similarly, PFS was inferior in AB users in n = 13 studies with data available (HR = 1.53, 95%CI 1.22–1.93; p < 0.01). In cancer patients treated with ICIs, AB use significantly reduced OS and PFS. Short duration/course of ABs may be considered in clinical situations in which they are strictly needed. MDPI 2020-05-13 /pmc/articles/PMC7290584/ /pubmed/32414103 http://dx.doi.org/10.3390/jcm9051458 Text en © 2020 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Communication
Petrelli, Fausto
Iaculli, Alessandro
Signorelli, Diego
Ghidini, Antonio
Dottorini, Lorenzo
Perego, Gianluca
Ghidini, Michele
Zaniboni, Alberto
Gori, Stefania
Inno, Alessandro
Survival of Patients Treated with Antibiotics and Immunotherapy for Cancer: A Systematic Review and Meta-Analysis
title Survival of Patients Treated with Antibiotics and Immunotherapy for Cancer: A Systematic Review and Meta-Analysis
title_full Survival of Patients Treated with Antibiotics and Immunotherapy for Cancer: A Systematic Review and Meta-Analysis
title_fullStr Survival of Patients Treated with Antibiotics and Immunotherapy for Cancer: A Systematic Review and Meta-Analysis
title_full_unstemmed Survival of Patients Treated with Antibiotics and Immunotherapy for Cancer: A Systematic Review and Meta-Analysis
title_short Survival of Patients Treated with Antibiotics and Immunotherapy for Cancer: A Systematic Review and Meta-Analysis
title_sort survival of patients treated with antibiotics and immunotherapy for cancer: a systematic review and meta-analysis
topic Communication
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7290584/
https://www.ncbi.nlm.nih.gov/pubmed/32414103
http://dx.doi.org/10.3390/jcm9051458
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