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Chao Huang



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    PD01 - Poster Discussion Session (ID 4)

    • Event: NACLC 2019
    • Type: Poster Discussion Session
    • Track:
    • Presentations: 1
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      PD01.19 - Beneficial Effect of Antibiotic Use in Patients With Stage IV NSCLC Treated With Immune Checkpoint Inhibitors. (ID 96)

      15:45 - 16:45  |  Presenting Author(s): Chao Huang

      • Abstract

      Background:
      The activity of immune checkpoint inhibitors (ICI) can be predicted by PD-L1 expression. Antibiotic (AB) use can affect the microbial flora which modulates the efficacy of ICI. Recent studies showed that antibiotic use had a deleterious effect on the activity of ICI in renal cell carcinoma and non-small cell lung cancer.


      Method:
      We performed a retrospective analysis of 121stage IV non-small cell lung cancer patients treated with ICI at our institution from 2015 to 2017. The impact of PD-L1 expression, steroid and antibiotic use as well as radiotherapy on their progression-free survival (PFS) and overall survival (OS) were analyzed using Kaplan-Meier survival curve. We determined the use of antibiotics and steroids during any time within 30 days of initiation of treatment with ICI.


      Results:
      The median age of the patients was 66; 57 females and 64 males; 23 current smokers, 11 non-smokers and 87 previous smokers; 87 adenocarcinomas, 24 squamous cell histology, and 10 others; 38 patients had low PD-L1 (< 50%), 46 had high PD-L1 (?50%) and 37 was unknown. Steroid and antibiotics were used in 57 and 59 patients, respectively. 77 patients received radiotherapy. The median progression free survival (PFS) and overall survival (OS) were 9.8 months and 14.5 months, respectively. On Univariate analysis, AB use was significantly associated improvement of PFS and OS compared to no AB use. These PSF and OS benefits were only observed in patients with high PD-L1 expression but not in patients with low PD-L1 expression (PFS of 24.3 vs. 4.7 months and OS of 31.4 vs 7.1 months). There was no significant impact of PD-L1 expression level, steroid use and treatment of radiotherapy on PFS nor OS.


      Conclusion:
      Our analysis showed that AB use in patient with NSCLC treated with ICI had a beneficial effect in PFS and OS. This finding is opposite from what has been reported in the literature. It is possible that some antibiotics can promote the development of beneficial microbial by eliminating deleterious flora. The analysis of the type of antibiotic used is underway.