Antibiotics May Compromise Immunotherapy Efficacy in Kidney Cancer

Patients with metastatic kidney cancer may see a decreased efficacy of their immunotherapy regimen if they recently took antibiotics.
BY LISA MILLER
PUBLISHED: FEBRUARY 14, 2017
“Derosa shows that antibiotic therapy may have a direct impact on how well the PD-1 inhibitor nivolumab works in patients with kidney cancer,” said Sumanta K. Pal, M.D., who moderated the presentation.

A multivariate analysis for prognostic risk factors showed a hazard ratio of 4.17 for patients who had not received antibiotics compared with those that had taken antibiotics. Patients with a lower Karnofsky performance statuses also showed an increased hazard ratio.

“Immune-based therapies for cancer may have a complex interplay with the host’s microbiome,” commented Pal, an assistant clinical professor in the Department of Medical Oncology and Therapeutics Research and co-director of the Kidney Cancer Program at City of Hope in Duarte, California. “Antibiotics may influence the bacterial composition of our gut, and this could in turn impact how effective immune therapy is.”

Derosa stated that the data was preliminary but that it encouraged longer follow-up and further studies to confirm the hypothesis of the study.

“The observations that Derosa makes have some consistency with preclinical observation,” Pal said. “We may be able to offer some insights as to whether or not bacterial composition of the gut could affect clinical outcomes and that might help us guide antibiotic usage.” Pal also suggested that these findings are not yet mature enough to impact clinical practice. The researchers plan to enroll additional patients in this study to investigate the mechanism of action. Other studies exploring the relationship between antibiotics and the efficacy of immunotherapy agents in lung cancer and kidney cancer are ongoing.
 
 

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