Effect of concomitant antibiotics use on patient outcomes and adverse effects in patients treated with ICIs

Abstract

Background: Immune checkpoint inhibitors (ICIs) such as PD-1/PD-L1/CTLA-4 inhibitors have brought new opportunities for the cure of cancer patients and have been widely used and which are the most successful cancer immunotherapy drug in recent years. Gut microbiome and metabolites exert a critical regulatory function in cancer immunotherapy of ICIs, which can be affected by antibiotics intervention. However, inflammatory infections caused by impaired immune function in tumor patients often require antibiotic treatment.

Objective: In this review, we briefly discussed the correlation between antibiotics and ICIs treatment to evaluate the impact of antibiotics on cancer progression.

Methods: By searches of PubMed, we collected the data such as progression-free survival time (PFS) and overall survival time (OS) in patients with non-small cell lung cancer (NSCLC), kidney cancer, Melanoma, colorectal cancer, and other tumors.

Results: Antibiotics have a negative effect on the prolongation of survival in cancer patients treated with ICIs. This may depend on the patient's cancer type and the type of ICIs and antibiotics they have used.

Conclusions: Antibiotics may reduce the effectiveness of immunotherapy by depleting the body's microbiome. Therefore, paying attention to the changes in the level of microorganisms in cancer patients, while making more individualized and precise improvements in treatment regimens, may bring new opportunities to improve the efficacy of immunotherapy.

Keywords:

• Antibiotics
• immune checkpoint inhibitors
• tumors
• microbiota
• cancer immune therapy

Disclosure statement

Jiuhang Yu, Yichuang Yin, Yang Yu, Mengfei Cheng, Shuo Zhang, Shuai Jiang and Mei Dong declare that they have no commercial or associative interests that represent a conflict of interest in connection with the work submitted.

Additional information

Funding

This work was supported by Project of Beijing Medical Award Foundation [YXJL-2022-0187-0013] and Beijing Hongdingxiang Public Welfare Development Center [BJ-HDX-20220437].