The Association Between Antibiotic Use and Outcome Among Metastatic Melanoma Patients Receiving Immunotherapy - Université d'Angers Accéder directement au contenu
Article Dans Une Revue JNCI: Journal of the National Cancer Institute Année : 2022

The Association Between Antibiotic Use and Outcome Among Metastatic Melanoma Patients Receiving Immunotherapy

Thierry Lesimple

Résumé

BACKGROUND: Several observational studies have reported a decreased response to immune checkpoint inhibitors (ICI) following antibiotic use. ICI activity has been hypothesized to be impaired by antibiotic-induced gut dysbiosis. METHODS: Patients with advanced melanoma receiving an anti-PD-1 antibody as a first-line therapy between 2015 and 2017 in France were selected using the French Health Insurance database. We compared overall survival (OS) and time-to-treatment discontinuation (TTD) according to antibiotic exposure in the 3 months prior to the initiation of anti-PD-1 antibody. To disentangle a causal effect of antibiotics from a confounding bias, we balanced characteristics of patients exposed and non-exposed to antibiotics using an overlap weighting method based on a propensity score. We also evaluated a control cohort of patients with advanced melanoma receiving first-line targeted therapy, as there is no rationale for decreased efficacy of targeted therapy following antibiotic treatment. RESULTS: The anti-PD-1 antibody cohort comprised 2605 individuals. Antibiotic exposure in the 3 months prior to anti-PD-1 antibody initiation was not associated with shorter OS (weighted hazard ratio = 1.01, 95% confidence interval = 0.88-1.17) or TTD (weighted hazard ratio = 1.00, 95% confidence interval = 0.89-1.11). Consistent results were observed when the timeframe of antibiotics was narrowed to 1 month prior to anti-PD-1 initiation, or when exposure was restricted to antibiotics leading to more profound gut dysbiosis. Similar results were observed in the targeted therapy cohort. CONCLUSIONS: In a large cohort of advanced melanoma patients, we showed that antibiotic use preceding anti-PD-1 antibody was not associated with worse outcome. Physicians should not delay immunotherapy for patients who have recently received antibiotics.
Fichier principal
Vignette du fichier
Poizeau et al-2022-The Association Between Antibiotic Use and Outcome Among Metastatic Melanoma.pdf (2.24 Mo) Télécharger le fichier
Poizeau_djac019_supplementary_data.pdf (237.97 Ko) Télécharger le fichier
Origine : Fichiers produits par l'(les) auteur(s)

Dates et versions

hal-03610858 , version 1 (12-04-2022)

Licence

Paternité - Pas d'utilisation commerciale

Identifiants

Citer

Florence Poizeau, Sandrine Kerbrat, Frédéric Balusson, Pierre Tattevin, Matthieu Revest, et al.. The Association Between Antibiotic Use and Outcome Among Metastatic Melanoma Patients Receiving Immunotherapy. JNCI: Journal of the National Cancer Institute, 2022, 114 (5), pp.686-694. ⟨10.1093/jnci/djac019⟩. ⟨hal-03610858⟩
128 Consultations
69 Téléchargements

Altmetric

Partager

Gmail Facebook X LinkedIn More