文章：

免疫检查点抑制剂使用前抗生素使用时长对复发性妇科恶性肿瘤患者总生存期的不良影响

Adverse Effect of the Duration of Antibiotic Use Prior to Immune Checkpoint Inhibitors on the Overall Survival of Patients with Recurrent Gynecologic Malignancies

原文发布日期：7 December 2023

DOI: 10.3390/cancers15245745

类型: Article

开放获取: 是

英文摘要：

Purpose: Antibiotic use preceding immune checkpoint inhibitor (ICI) treatment has been associated with a decreased efficacy of ICI in solid tumors. In this study, we evaluated the effect of antibiotic use before ICI therapy on oncological outcomes. Methods: We examined patients with recurrent gynecologic malignancies at two academic institutions. The clinical data, including antibiotic use within 60 days of ICI initiation, type of antibiotics, reasons for antibiotic use, body mass index, tumor site, chemotherapy-free interval, prior history of radiotherapy, disease control rate (DCR), and overall survival (OS), were assessed. Results: Of 215 patients, 22.9% (n= 47) received antibiotics before ICI treatment. The most common cancer was ovarian (52.1%,n= 112), followed by cervical (24.7%,n= 53) and endometrial (16.7%,n= 36). When we divided the cohort based on antibiotic use before ICIs, there were no significant differences in the DCR and baseline characteristics between the two groups. On multivariate analyses, the variables associated with poor OS were previous use of antibiotics for a cumulative duration of >14 days (HR 2.286, 95% CI 1.210–4.318;p= 0.011); Eastern Cooperative Oncology Group 2 or 3 (HR 4.677, 95% CI 2.497–8.762;p< 0.001); and chemotherapy-free interval of <6 months (HR 2.007, 95% CI 1.055–3.819;p= 0.034). Conclusion: Prior use of antibiotics for a cumulative duration of >14 days was associated with reduced survival in recurrent gynecologic malignancies.

摘要翻译： 

目的：在实体瘤治疗中，免疫检查点抑制剂（ICI）治疗前使用抗生素与ICI疗效降低相关。本研究评估了ICI治疗前使用抗生素对肿瘤学结局的影响。方法：我们回顾性分析了两家学术机构收治的复发性妇科恶性肿瘤患者。评估的临床数据包括：ICI启动前60天内抗生素使用情况、抗生素类型、使用原因、体重指数、肿瘤部位、无化疗间期、既往放疗史、疾病控制率（DCR）及总生存期（OS）。结果：在215例患者中，22.9%（n=47）在ICI治疗前使用了抗生素。最常见的癌症类型为卵巢癌（52.1%，n=112），其次为宫颈癌（24.7%，n=53）和子宫内膜癌（16.7%，n=36）。根据ICI治疗前是否使用抗生素将队列分组后，两组间的DCR及基线特征无显著差异。多变量分析显示，与不良OS相关的变量包括：既往抗生素累计使用时间>14天（HR 2.286，95% CI 1.210–4.318；p=0.011）、东部肿瘤协作组体能状态评分为2或3分（HR 4.677，95% CI 2.497–8.762；p<0.001）以及无化疗间期<6个月（HR 2.007，95% CI 1.055–3.819；p=0.034）。结论：在复发性妇科恶性肿瘤中，既往抗生素累计使用时间超过14天与患者生存期缩短相关。

原文链接：

Adverse Effect of the Duration of Antibiotic Use Prior to Immune Checkpoint Inhibitors on the Overall Survival of Patients with Recurrent Gynecologic Malignancies