{"title":"Impact of antibiotic use on survival in patients with advanced non-small cell lung cancer treated with immune checkpoint inhibitor and chemotherapy.","authors":"Nobuaki Ochi, Eiki Ichihara, Toshihide Yokoyama, Koji Inoue, Tomoki Tamura, Hiromi Watanabe, Ichiro Takata, Hirohisa Kano, Kayo Nakamura, Haruyuki Kawai, Masaaki Inoue, Nobukazu Fujimoto, Hirohisa Ichikawa, Chihiro Ando, Isao Oze, Nagio Takigawa, Yoshinobu Maeda, Katsuyuki Hotta","doi":"10.1007/s10147-025-02860-9","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Evidence suggests that antibiotic (ATB) use may negatively impact the efficacy of immune checkpoint inhibitors (ICIs) in treating advanced non-small cell lung cancer (NSCLC). We previously demonstrated that ATB use was significantly associated with decreased survival in NSCLC patients receiving ICI monotherapy. This study aimed to investigate the effect of ATB use on survival in NSCLC patients undergoing combined ICI and chemotherapy.</p><p><strong>Patients and methods: </strong>We evaluated the impact of ATB on survival in NSCLC patients treated with ICIs and chemotherapy in this multicenter retrospective study. We analyzed outcomes such as progression-free survival (PFS) and overall survival (OS) in patients who received ATB within 2 months before or 1 month after starting ICI and chemotherapy combination therapy.</p><p><strong>Results: </strong>Among 451 patients, 113 received ATB (ATB group) and 338 did not (ATB-unexposed). The median PFS was 7.1 months in the ATB group and 8.4 months in the ATB-unexposed group. The median OS was 18.0 months in the ATB group compared to 23.8 months in the ATB-unexposed group, indicating a significant reduction in both PFS and OS for the ATB group. Notably, this negative impact was not observed in patients who used probiotics (PFS: 6.0 vs. 7.6 months, p = 0.355; OS: 16.7 months vs. not reached (NR), p = 0.179).</p><p><strong>Conclusion: </strong>ATB use was significantly associated with poorer survival outcomes in NSCLC patients treated with combined ICI and chemotherapy, but this effect was attenuated by probiotics.</p>","PeriodicalId":13869,"journal":{"name":"International Journal of Clinical Oncology","volume":" ","pages":""},"PeriodicalIF":2.8000,"publicationDate":"2025-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"International Journal of Clinical Oncology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1007/s10147-025-02860-9","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"ONCOLOGY","Score":null,"Total":0}
引用次数: 0
Abstract
Background: Evidence suggests that antibiotic (ATB) use may negatively impact the efficacy of immune checkpoint inhibitors (ICIs) in treating advanced non-small cell lung cancer (NSCLC). We previously demonstrated that ATB use was significantly associated with decreased survival in NSCLC patients receiving ICI monotherapy. This study aimed to investigate the effect of ATB use on survival in NSCLC patients undergoing combined ICI and chemotherapy.
Patients and methods: We evaluated the impact of ATB on survival in NSCLC patients treated with ICIs and chemotherapy in this multicenter retrospective study. We analyzed outcomes such as progression-free survival (PFS) and overall survival (OS) in patients who received ATB within 2 months before or 1 month after starting ICI and chemotherapy combination therapy.
Results: Among 451 patients, 113 received ATB (ATB group) and 338 did not (ATB-unexposed). The median PFS was 7.1 months in the ATB group and 8.4 months in the ATB-unexposed group. The median OS was 18.0 months in the ATB group compared to 23.8 months in the ATB-unexposed group, indicating a significant reduction in both PFS and OS for the ATB group. Notably, this negative impact was not observed in patients who used probiotics (PFS: 6.0 vs. 7.6 months, p = 0.355; OS: 16.7 months vs. not reached (NR), p = 0.179).
Conclusion: ATB use was significantly associated with poorer survival outcomes in NSCLC patients treated with combined ICI and chemotherapy, but this effect was attenuated by probiotics.
期刊介绍：
The International Journal of Clinical Oncology (IJCO) welcomes original research papers on all aspects of clinical oncology that report the results of novel and timely investigations. Reports on clinical trials are encouraged. Experimental studies will also be accepted if they have obvious relevance to clinical oncology. Membership in the Japan Society of Clinical Oncology is not a prerequisite for submission to the journal. Papers are received on the understanding that: their contents have not been published in whole or in part elsewhere; that they are subject to peer review by at least two referees and the Editors, and to editorial revision of the language and contents; and that the Editors are responsible for their acceptance, rejection, and order of publication.
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