Real-Practice Analysis of Potential Antibiotic Interactions in Patients Treated With Immune Checkpoint Inhibitors: An Observational Study From an Italian Referral Cancer Center

IF 2.1 4区医学 Q3 PHARMACOLOGY & PHARMACY

Journal of Clinical Pharmacy and Therapeutics Pub Date : 2025-02-28 DOI:10.1155/jcpt/5572209

Alberto Russi, Camilla Saran, Giulia Zanchetta, Giorgia Zorzetto, Giovanna Crivellaro, Marco Maruzzo, Giulia Pasello, Alessio Fabozzi, Chiara De Toni, Carola Cenzi, Elena Berti, Silvia Cognolato, Francesca Pipitone, Alberto Bortolami, Alice Capogrosso Sansone, Chiara Salvato, Francesca Bano, Ugo Moretti, Paola De Ambrosis, Giovanna Scroccaro, Marina Coppola

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引用次数: 0

Abstract

Purpose: Inappropriate use of antibiotics contributes to the increase in antimicrobial resistance with negative health safety implications. Global health organizations have promoted projects to improve proper and rational use of antibiotics. Recent studies show how antibiotics can also influence the efficacy of immune checkpoint inhibitors (ICIs) treatment in cancer patients. This work analyzes the impact of concomitant antibiotic therapy in patients affected by skin, lung, and kidney cancer, who started immunotherapy in 2020-2021 at Veneto Institute of Oncology IRCCS. The aim of this study is to evaluate clinical outcomes, treatment efficacy, discontinuation causes, and occurrence of adverse drug reactions in cancer patients treated with ICIs.

Methods: Data from the real-world retrospective study were extracted from Territorial Pharmaceutical Care databases, medical records, and the AIFA registry. A descriptive analysis of the study population was performed, as well as of patient outcomes in terms of progression-free survival (PFS) and overall survival (OS).

Results: A total of 239 subjects affected by kidney (8%), lung (48%), and skin (44%) cancer were enrolled; of these, 50%, 32%, 9%, and 9% were treated with single-agent nivolumab, pembrolizumab, atezolizumab, and cemiplimab, respectively. A total of 119 patients received concomitant antibiotic therapy. Median OS was 8.8 months (95% CI: 5.02–11.8) and 31.05 months (95% CI: 24.81–NA) in subjects with high and low antibiotic exposure, respectively. Multivariate subgroup analysis confirmed that high antibiotic exposure is an unfavorable factor also for median PFS.

Conclusion: A prolonged exposure to antibiotics correlates with unfavorable outcomes in cancer patients undergoing concomitant immunotherapy. Thus, managing antibiotic exposure is fundamental for optimizing ICI treatment.

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查看原文本刊更多论文

在接受免疫检查点抑制剂治疗的患者中潜在抗生素相互作用的实际分析：来自意大利转诊癌症中心的一项观察性研究

目的：不适当使用抗生素会增加抗菌素耐药性，并对健康安全产生负面影响。全球卫生组织推动了改善适当和合理使用抗生素的项目。最近的研究表明，抗生素也可以影响免疫检查点抑制剂（ICIs）治疗癌症患者的疗效。这项工作分析了伴随抗生素治疗对皮肤、肺癌和肾癌患者的影响，这些患者于2020-2021年在威尼托肿瘤研究所IRCCS开始免疫治疗。本研究的目的是评估使用ICIs治疗的癌症患者的临床结局、治疗效果、停药原因和药物不良反应的发生情况。方法：来自真实世界回顾性研究的数据提取自领土医药保健数据库、医疗记录和AIFA登记处。对研究人群以及患者无进展生存期（PFS）和总生存期（OS）进行了描述性分析。结果：共有239名受试者被纳入肾癌（8%）、肺癌（48%）和皮肤癌（44%）；其中，分别有50%、32%、9%和9%的患者接受单药纳武单抗、派姆单抗、阿特唑单抗和西米单抗治疗。共有119例患者接受了联合抗生素治疗。抗生素高暴露组和低暴露组的中位生存期分别为8.8个月（95% CI: 5.02-11.8）和31.05个月（95% CI: 24.81-NA）。多变量亚组分析证实，高抗生素暴露也是中位PFS的不利因素。结论：长期暴露于抗生素与癌症患者同时接受免疫治疗的不良结果相关。因此，管理抗生素暴露是优化ICI治疗的基础。

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来源期刊

Journal of Clinical Pharmacy and Therapeutics 医学-药学

CiteScore

4.10

自引率

5.00%

发文量

226

审稿时长

6 months

期刊介绍： The Journal of Clinical Pharmacy and Therapeutics provides a forum for clinicians, pharmacists and pharmacologists to explore and report on issues of common interest. Reports and commentaries on current issues in medical and pharmaceutical practice are encouraged. Papers on evidence-based clinical practice and multidisciplinary collaborative work are particularly welcome. Regular sections in the journal include: editorials, commentaries, reviews (including systematic overviews and meta-analyses), original research and reports, and book reviews. Its scope embraces all aspects of clinical drug development and therapeutics, including: Rational therapeutics Evidence-based practice Safety, cost-effectiveness and clinical efficacy of drugs Drug interactions Clinical impact of drug formulations Pharmacogenetics Personalised, stratified and translational medicine Clinical pharmacokinetics.