Trial reportEuropean urology2021
Is There a Detrimental Effect of Antibiotic Therapy in Patients with Muscle-invasive Bladder Cancer Treated with Neoadjuvant Pembrolizumab?
Trial report in European urology, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 39 papers, 2 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
39 citing papers in PubMed, 2 syntheses or guidelines pooled it, 52 citations in OpenAlex.
- The use of antibiotic, probiotic, and fecal microbiota transplantation in modulating immunotherapy efficacy and survival: a systematic review and meta-analysis of clinical outcomes.The oncologist · 2026Pooled it
- Uncovering the role of urinary microbiota in urological tumors: a systematic review of literature.World journal of urology · 2022Pooled it
- Microbiota as a modulator of drug response: targeting microbial-drug crosstalk in cancer therapy.Gut microbes · 2026Review
- Evolution toward early stent removal and reduced antibiotic prophylaxis post-cystectomy.The Canadian journal of urology · 2026Article
- Microbiome-Modulating Strategies in Anticancer Therapy: A Review of Current Evidence and Recommendations for Further Treatment Improvement.Probiotics and antimicrobial proteins · 2026Review
- Influence of Gut Microbiota on Response to Immune Check Point Inhibitors in MASLD Patients With HCC: Unraveling the Connection.Cancer medicine · 2026Review
- Neoadjuvant Therapy in Cisplatin-Ineligible Muscle-Invasive Bladder Cancer: Recent Progress, Challenges, and Future Directions in the Era of TAR-200 and Enfortumab Vedotin Plus Pembrolizumab.Oncology and therapy · 2026Review
- Review
- Ecological and Functional Stratification of the Stool Microbiome Predicts Response to Immune Checkpoint Inhibitors across Cancer Types.Computational and structural biotechnology journal · 2026Article
- Prognostic and predictive factors of immune checkpoint inhibitor therapy in urinary bladder cancer.Pathology oncology research : POR · 2026Review
- New Highlights: The Microbiome of Bronchoalveolar Lavage Fluid Predicts the Prognosis of Lung Cancer.Phenomics (Cham, Switzerland) · 2025Article
- Identification and Evaluation of the Urinary Microbiota Associated With Bladder Cancer.Cancer innovation · 2025Article
- Urine-Stable Aptamer-Conjugated Gold Nanorods for the Early Detection of High-Grade Bladder Cancer Residual Disease.Advanced healthcare materials · 2025Article
- Association between antibiotics and treatment efficacy in metastatic urothelial carcinoma patients.BMC medicine · 2025Article
- Tumor microbiome: roles in tumor initiation, progression, and therapy.Molecular biomedicine · 2025Review
- Effects of antibiotics on the anti-tumor efficacy of immune checkpoint inhibitor therapy.Clinical & translational oncology : official publication of the Federation of Spanish Oncology Societies and of the National Cancer Institute of Mexico · 2025Article
- Deciphering the urinary microbiome and urological cancers: from correlation to mechanisms and treatment.Frontiers in microbiology · 2025Review
- The impact of antibiotic use on outcomes of relapsed/refractory multiple myeloma patients treated with CAR-T therapy.Frontiers in immunology · 2025Article
- Cutibacterium acnes-derived extracellular vesicles promote tumor growth in renal cell carcinoma.Cancer science · 2024Article
- Perfusion drugs for non‑muscle invasive bladder cancer (Review).Oncology letters · 2024Review
Corrections and comments
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Authors and funding
12 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
In locally advanced and metastatic malignancies, antibiotic (ATB) therapy has a negative effect on immunotherapy efficacy. Therefore, we aimed to evaluate whether ATB therapy and use of specific ATB classes with concomitant neoadjuvant pembrolizumab affected pathologic complete response (ypT0N0) and relapse-free survival (RFS) for patients with clinical T2-4N0M0 bladder cancer enrolled in the PURE-01 study. Of the 149 patients evaluated, 48 (32%) received any concomitant ATB therapy. The ATB class most commonly administered was fluoroquinolones (16 patients; 33%). In the ATB cohort, seven patients (15%) achieved ypT0N0 status, compared to 50 (50%; p < 0.001) in the untreated group. Moreover, ATB use was negatively associated with ypT0N0 status (odds ratio 0.18, 95% confidence interval [CI] 0.05-0.48; p = 0.001). The 24-mo RFS rate was 63% (95% CI 48-83%) in the ATB group versus 90% (95% CI 83-97) in the untreated group. We found that ATB use was associated with a higher recurrence rate (hazard ratio [HR] 2.64, 95% CI 1.08-6.50; p = 0.03). Exploratory analyses showed that fluoroquinolone use was associated with a higher recurrence rate (HR 3.28, 95% CI 1.12-9.60; p = 0.03). Our study revealed an association between ATB use and neoadjuvant immunotherapy efficacy in an intention-to-cure population, highlighting the need for future studies to better investigate this relationship. PATIENT SUMMARY: The efficacy of immunotherapy for cancer is influenced by several patient and tumor factors, including the use of antibiotics. We found that antibiotics taken at the same time as immunotherapy drugs were associated with lower rates of complete response and of recurrence-free survival among patients with muscle-invasive bladder cancer. These findings need to be confirmed in future studies.
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