抗生素使用与免疫检查点抑制剂治疗癌症患者结局的关系：系统评价和荟萃分析。
The association between antibiotics use and outcome of cancer patients treated with immune checkpoint inhibitors: A systematic review and meta-analysis.
机构信息
Department of Oncology, The Fifth Hospital of Wuhan, Xianzheng Road, Hanyang District, Wuhan, Hubei 430000, China.
Department of Oncology, Renmin Hospital of Wuhan University, Jiefang Road #238 Wuchang District, Wuhan 430000, China.
出版信息
Crit Rev Oncol Hematol. 2020 May;149:102909. doi: 10.1016/j.critrevonc.2020.102909. Epub 2020 Feb 19.
OBJECTIVE
This meta-analysis was to evaluate the impact of antibiotics use on survival of cancer patients with immune checkpoint inhibitors (ICIs).
METHODS
Electronic databases including Pubmed, Emabse, and the Cochrane library were searched. The primary endpoints were overall survival (OS) and progression-free survival (PFS).
RESULTS
A total of 20 retrospective studies were included. The median OS (7.9 months versus 17.65 months) and PFS (2.4 months versus 4.4 months) of the antibiotics use group were shorter compared to control group. Meta-analysis also showed that the risks of death (HR = 1.90, 95 % CI: 1.55-2.34; P < 0.01) and disease progression (HR=1.53, 95 % CI: 1.30-1.79; P < 0.01) in antibiotics positive group were significantly higher than that of the negative group. The prognostic role of antibiotics use was still significant regardless of cancer types and timing of antibiotics (P < 0.01 for all).
CONCLUSION
Use of antibiotics may be associated with worse outcomes in cancer patients treated with ICIs.
目的
本荟萃分析旨在评估抗生素使用对接受免疫检查点抑制剂（ICI）治疗的癌症患者生存的影响。
方法
检索了电子数据库，包括 Pubmed、Embase 和 Cochrane 图书馆。主要终点是总生存期（OS）和无进展生存期（PFS）。
结果
共纳入 20 项回顾性研究。与对照组相比，抗生素使用组的中位 OS（7.9 个月与 17.65 个月）和 PFS（2.4 个月与 4.4 个月）更短。荟萃分析还表明，抗生素阳性组的死亡风险（HR=1.90，95%CI：1.55-2.34；P<0.01）和疾病进展风险（HR=1.53，95%CI：1.30-1.79；P<0.01）明显高于阴性组。无论癌症类型和抗生素使用时间如何（所有 P<0.01），抗生素使用的预后作用仍然显著。
结论
在接受 ICI 治疗的癌症患者中，抗生素的使用可能与更差的结局相关。
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