Antibiotics May Reduce Survival in Renal Cancer

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First analysis evaluating the impact of broad-spectrum antibiotics in mRCC patients treated in the era of immune checkpoint inhibitors. <i>Photo Credit: CDC/Dr Edwin P. Ewing, Jr.</i>
First analysis evaluating the impact of broad-spectrum antibiotics in mRCC patients treated in the era of immune checkpoint inhibitors. Photo Credit: CDC/Dr Edwin P. Ewing, Jr.

HealthDay News — For patients with metastatic renal cell carcinoma (mRCC) receiving immune checkpoint inhibitors, treatment with broad-spectrum antibiotics (ATBs) can reduce progression-free survival, according to research presented at the American Society of Clinical Oncology's annual Genitourinary Cancers Symposium in Orlando, Florida.

Lisa Derosa, MD, from the Gustave Roussy Cancer Institute at the Paris-Sud University in Villejuif, France, and colleagues examined the effect of ATB use in mRCC patients treated with immune checkpoint inhibitors in a retrospective analysis of patients treated in prospective trials. Eighty patients were enrolled who were treated with anti-PD-1/PD-L1 monotherapy (67 patients), anti-PD-1 plus CTLA-4 (10 patients), or anti-PD-L1 plus bevacizumab (3 patients). Twenty percent of patients were treated with ATB, mostly beta-lactamases and fluoroquinolones.

The researchers found that patients treated with ABT had decreased progression-free survival compared with those not receiving ATB (2.3 months vs 8.1 months; <.001). After multivariate adjustment for age, gender, International Metastatic Renal-Cell Carcinoma Database Consortium risk groups, tumor burden, and proton pump inhibitors, the statistically significant correlation persisted. Objective response rate was lower in those treated with ATB (<.002). There was a negative trend toward overall survival for patients treated with ATB, although it was too early to draw conclusions (median follow-up of less than 6 months).

"These early findings show that doctors prescribing cancer immunotherapy should pay closer attention to antibiotic use," Dr Derosa said in a statement.

Several authors disclosed financial ties to the pharmaceutical industry.

Reference

Derosa L, Routy B, Enot D, et al. Impact of antibiotics on outcome in patients with metastatic renal cell carcinoma treated with immune checkpoint inhibitors. Presented at the 2017 Genitourinary Cancers Symposium. J Clin Oncol. 2017;35:suppl 6S. Abstract 462.

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