Author of

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  P30 - Palliative and Supportive Care (ID 163)

  • Event: WCLC 2020
  • Type: Posters
  • Track: Palliative and Supportive Care
  • Presentations: 1
  • Moderators:
  • Coordinates: 1/28/2021, 00:00 - 00:00, ePoster Hall

  • 35498

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    P30.09 - Exposure to Antibiotics May Affect Progression-Free Survival Negatively in NSCLC Patients Receiving First-Line Chemotherapy (ID 1719)

    00:00 - 00:00  |  Presenting Author(s): xiaoman Tian
    • Abstract
    • Slides

    Introduction
    

    Pre-clinical and clinical data indicates the microbiome plays an important role in carcinogenesis and influences response to PD-1/PD-L1 inhibitors among patients with several solid tumors. Also, chemotherapeutic regimens have been shown to disrupt the intestinal barrier and promote antitumor efficacy in humans and mice. From this point of view, exposure to antibiotics before systematic therapy might have impacts on the clinical outcomes in non-small cell lung cancer (NSCLC) patients receiving first-line chemotherapy.

    Methods
    

    Between Jan 2015 and Dec 2018, patients with pathologically confirmed NSCLC who had received first-line chemotherapy in West China Hospital and Sichuan Provincial People's Hospital were recruited in present study. The definition of “exposure to antibiotics” was an at least 7-day period antibiotic exposure 21 days before chemotherapeutic regimens infusion in the first-line settings. Progression-free survival (PFS) among patients with or without exposure to antibiotics (Exposure group or Control group) were analyzed using the Kaplan-Meier method and the Cox proportional hazard models.. The p value was considered statistically significant if less than 0.05.

    Results
    

    Totally, 2212 patients with NSCLC were retrospectively analyzed, and 1021 advanced stage cases with the ECOG PS 0-1 receiving first-line chemotherapy were recruited in present study. The population exposed to antibiotics was 41.6% (425/1021). Compared to the PFS in Exposure group [4.1 months, 95% confidence interval (CI) 3.5-4.7 months], the median PFS in Control group was significantly prolonged (6.6 months, 95% CI 6.1-7.0 months), with a hazard ratio (HR) of 0.48 (95% CI 0.39-0.60, p<0.001). In addition, the difference of PFS between patients with non-squamous (median 6.1 months, 95% CI 5.6-6.6 months) and squamous cell NSCLC (median 5.2 months, 95% CI 4.6-5.8 months) was significant (p=0.038). No association was observed between the PFS and the other clinical characteristics (such as age, gender, brain or liver metastasis) (all p>0.05). Among patients exposed to antibiotics, the median PFS were similar depending on the different kinds of drugs prescribed (for Penicillin: 4.1 months, 95% CI 3.2-5.0 months; for Cephalosporin: 3.9 months, 95% CI 2.9-4.9 months and for Quinolones: 4.1 months, 95% CI 2.9-5.4 months) (p= 0.91).

    

    Conclusion
    

    Although its retrospective nature and relative small sample size, our data indicated that exposure to antibiotics might negatively affect the PFS of NSCLC patients receiving first-line chemotherapy, calling attention to the unnecessary antibiotics prescription before systematic treatment in practice. The analysis of overall survival was ongoing in a larger multi-center population.

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