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Broad-spectrum antibiotic regimen affects survival in patients receiving nivolumab for non-small cell lung cancer
- Title
- Broad-spectrum antibiotic regimen affects survival in patients receiving nivolumab for non-small cell lung cancer
- Authors
- Geum M.J.; Kim C.; Kang J.E.; Choi J.H.; Kim J.S.; Son E.S.; Lim S.M.; Rhie S.J.
- Ewha Authors
- 이정연; 강지은
- SCOPUS Author ID
- 이정연; 강지은
- Issue Date
- 2021
- Journal Title
- Pharmaceuticals
- ISSN
- 1424-8247
- Citation
- Pharmaceuticals vol. 14, no. 5
- Keywords
- Antibiotic-induced dysbiosis; Days of therapy; Defined daily dose; Nivolumab; Non-small cell lung cancer; Overall survival
- Publisher
- MDPI AG
- Indexed
- SCIE; SCOPUS
- Document Type
- Article
- Abstract
- Antibiotic-induced dysbiosis may affect the efficacy of immune checkpoint inhibitors. We investigated the impact of antibiotics on the clinical outcomes of nivolumab in patients with non-small cell lung cancer (NSCLC). Patients who received nivolumab for NSCLC between July 2015 and June 2018 and who were followed up until June 2020 were included in a retrospective cohort analysis. Of 140 eligible patients, 70 were on antibiotics. Overall survival (OS) was shorter in patients on antibiotics (ABX) compared to those not on antibiotics (NoABX) (p = 0.014). OS was negatively associated with piperacillin/tazobactam (PTZ) (HR = 3.31, 95% CI: 1.77–6.18), days of therapy (DOT) ≥ 2 weeks (HR = 2.56, 95% CI: 1.30–5.22) and DOT of PTZ. The defined daily dose (DDD) in PTZ (r = 0.27) and glycopeptides (r = 0.21) showed weak correlations with mortality. There was no difference in progression-free survival (PFS) between ABX and NoABX; however, PFS was negatively associated with the antibiotic class PTZ and DOT of PTZ. Therefore, the use of a broad-spectrum antibiotic, such as PTZ, the long-term use of antibiotics more than 2 weeks in total and the large amount of defined daily dose of specific antibiotics were associated with decreased survival in patients receiving nivolumab for NSCLC. © 2021 by the authors. Licensee MDPI, Basel, Switzerland.
- DOI
- 10.3390/ph14050445
- Appears in Collections:
- 약학대학 > 약학과 > Journal papers
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