Evidence map›Paper›PMID 34777340›Full record

ArticleFrontiers in immunology2021

Impact of Antibiotics and Proton Pump Inhibitors on Efficacy and Tolerance of Anti-PD-1 Immune Checkpoint Inhibitors.

Quentin Giordan, Julia Salleron, Catherine Vallance, Clothilde Moriana, Christelle Clement-Duchene

Open access · goldAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Frontiers in immunology, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 58 papers, 8 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
58citing papers in PubMed, 8 pooled it
5.2field-weighted citation impact, top 3% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

58 citing papers in PubMed, 8 syntheses or guidelines pooled it, 78 citations in OpenAlex.

  1. Pooled it
  2. Guideline
  3. Pooled it
  4. Pooled it
  5. Pooled it
  6. Pooled it
  7. Pooled it
  8. Pooled it
  9. Trial
  10. Trial
  11. Article
  12. Observational
  13. Article
  14. Review
  15. Article
  16. Article
  17. Article
  18. Observational
  19. Article
  20. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors at 3 institutions in 1 country.

Quentin GiordanDepartment of Pharmacy, Centre Hospitalier Régional de Metz-Thionville, Metz, France.
Julia SalleronBiostatistics Unit, Institut de Cancérologie de Lorraine, Vandœuvre-lès-Nancy, France.
Catherine VallanceDepartment of Pharmacy, Institut de Cancérologie de Lorraine, Vandœuvre-lès-Nancy, France.
Clothilde MorianaDepartment of Internal Medicine, Centre Hospitalier Régional Universitaire de Nancy, Vandœuvre-lès-Nancy, France.
Christelle Clement-DucheneDepartment of Medical Oncology, Institut de Cancérologie de Lorraine, Vandœuvre-lès-Nancy, France.
Institut de Cancérologie de Lorraine · FRCentre Hospitalier Régional de Metz-Thionville · FRCentre Hospitalier Régional et Universitaire de Nancy · FR

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background: The use of antibiotics (ATB) and proton-pump inhibitors (PPI) alters the composition and diversity of the gut microbiota, which can influence the immune system, consequently interfering with response to anti-PD1 immune checkpoint inhibitors (ICI). We assessed the impact of ATB and/or PPI use on the efficacy and safety of ICI. Methods: Two hundred twelve patients treated with anti-PD1 ICI for non-small cell lung carcinoma, melanoma, upper airway & digestive tract carcinoma or renal cell carcinoma were retrospectively included. Patients having received ATB within 60 days before ICI initiation were included in the ATB+ group. Patients having received PPI within 30 days before ICI initiation were included in the PPI+ group. Four groups were thus considered: ATB-/PPI-, ATB+/PPI-, ATB-/PPI+, ATB+/PPI+. Response rate was assessed by RECIST v1.1. Overall survival (OS), progression-free survival (PFS) and adverse events, recorded using Common Terminology Criteria for Adverse Events Version 5, were compared using inverse probability of treatment weighting to account for selection bias. Results: PFS at 6 months was 56.7 %, 95%CI (49.6%; 63.2%) and 47.2 %, 95%CI (39.8%;54.1%) at 12 months. OS was 81.6%, 95%CI (75.6%; 86.2%) at 6 months, and 69.4%, 95%CI (61.9%;75.7%) at 12 months. Compared to ATB-/PPI- group, PFS was lower for the ATB+/PPI- group [Hazard ratio (HR) 1.90, 95%CI (1.41;2.57)] and the ATB-/PPI+ group [HR 1.51, 95%CI (1.11;2.05)], and lowest in the ATB+/PPI+ group [HR 3.65, 95%CI (2.75;4.84)]. For OS, the use of ATB alone or PPI alone or in combination was a risk factor for death, with each increasing HR values by a similar magnitude, and the combination of ATB and PPI did not increase risk further. AEs were observed in 78 cases (36.8%) with no significant impact of ATB or PPI use. Conclusions: This study reveals that ATB and/or PPI use can alter response to anti-PD1 ICI, and the prognosis of cancer patients. The microbiota mechanisms involved in the response to ICI should be investigated to optimize patient management.

Indexed as

Drug InteractionsAdultAgedAnti-Bacterial AgentsCarcinoma, Non-Small-Cell LungFemaleHumansImmune Checkpoint InhibitorsLung NeoplasmsMaleMiddle AgedNeoplasm GradingNeoplasm StagingPrognosisProgrammed Cell Death 1 ReceptorProton Pump InhibitorsAnti-Bacterial AgentsImmune Checkpoint InhibitorsPDCD1 protein, humanProgrammed Cell Death 1 ReceptorProton Pump Inhibitorsantibioticshead and neck cancerimmune checkpoint inhibitors (ICI)melanomanon-small cell lung cancer (NSCLC)non-small-cell lung carcinoma (NSCLC)proton-pump inhibitor (PPI)renal cell carcinoma (RCC)

Identifiers

PMID34777340
PMCPMC8578856
OpenAlexW3209760804

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.