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Dian Wang



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    P2.04 - Immuno-oncology (ID 167)

    • Event: WCLC 2019
    • Type: Poster Viewing in the Exhibit Hall
    • Track: Immuno-oncology
    • Presentations: 1
    • Moderators:
    • Coordinates: 9/09/2019, 10:15 - 18:15, Exhibit Hall
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      P2.04-69 - Impact of Antibiotic Usage on Survival During Checkpoint Inhibitor Treatment of Non-Small Cell Lung Cancer (NSCLC) (ID 2741)

      10:15 - 18:15  |  Author(s): Dian Wang

      • Abstract

      Background

      Growing evidence suggests that the gut microbiome influences response to second line checkpoint inhibitor (ICI) therapy. Little has been reported about the influence of antibiotics (ABX) while on ICI.

      Method

      This is an IRB approved retrospective study. Patients with advanced (stage IV or relapsed disease) NSCLC that had progressed after platinum based chemotherapy and were subsequently treated with ICIs were identified from an institutional database. Demographics, ABX usage, and survival outcomes were recorded and analyzed. Cox proportional hazard models adjusted for age at diagnosis and sex were performed.

      Result

      161 NSCLC patients met inclusion criteria for this analysis and were treated with ICIs from 2015 to 2019. Median age was 66 years old (range 46-88) and 60% were female. Most patients had prior separate lines of systemic therapy (median 2 lines, range 1-4). Histological subtypes included adenocarcinoma (70%), squamous cell carcinoma (24%) and other histologies (6%). Median ICI treatment length was 2 months. ICIs included Nivolumab and Pembrolizumab. 58 patients (36%) had ABX usage in the 90 days prior to ICI initiation. 33 patients (20%) used ABX during ICI treatment. 71 patients (44%) had no ABX usage prior or during ICI treatment. There were no progression-free survival (PFS) differences for patients receiving antibiotics in the 90 days prior to treatment start (HR 1.024, p=0.92). The use of ABX during ICI therapy was associated with increased PFS (HR 0.597, p=0.02). There were no overall survival (OS) differences for patients receiving ABX in the 90 days prior to the start of ICI therapy (HR 1.122, p=0.64). The effect of ABX utilization on OS was not significant (HR 0.660, p=0.07).

      Conclusion

      Improved PFS and a trend toward improved OS was noted in patients receiving ABX during ICI therapy. This suggests that ABX during ICI therapy may not have a detrimental effect on outcomes. Further studies are needed to determine the regimen, length of ABX treatment and its relation to survival benefits or detriment prior to and during ICI therapy.