Role of antibiotic use, plasma citrulline and blood microbiome in advanced non-small cell lung cancer patients treated with nivolumab.
Role of antibiotic use, plasma citrulline and blood microbiome in advanced non-small cell lung cancer patients treated with nivolumab.
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DOI：
10.1186/s40425-019-0658-1
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发表时间：
2019-07-10
影响因子：
10.9
通讯作者：
Giroux Leprieur, Etienne
中科院分区：
文献类型：
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作者：
Ouaknine Krief, Julia;Helly de Tauriers, Pierre;Giroux Leprieur, Etienne
背景：最近的数据表明肠道微生物群和抗生素的使用对免疫检查点抑制剂功效的影响。我们的目的是评估早期使用抗生素 (EUA)、血液微生物组和血浆瓜氨酸（肠道屏障标志物）对纳武单抗治疗非小细胞肺癌 (NSCLC) 疗效的影响。方法：我们纳入了 2014 年至 2017 年在我们科室接受纳武单抗治疗的所有连续晚期 NSCLC 患者。在 (M) M0 和 M2 月对血液微生物组进行了分析。在 M0、M2、M4 和 M6 时评估瓜氨酸率。结果：纳入了 72 名患者（EUA 占 42%）。不使用 EUA 的总生存期 (OS)（中位 13.4 个月）比使用 EUA 的总生存期 (OS) 更长（5.1 个月，p=0.03）。 35 名患者 (49%) 有血浆样本。 M0 时的高瓜氨酸率（≥20μM）与肿瘤反应（p=0.084）和临床获益（纳武单抗 >6 个月）（p=0.002）相关。中位无进展生存期 (PFS) 为 7.9 个月（高瓜氨酸） vs 1.6 个月（低瓜氨酸） (p
BACKGROUND: Recent data suggested a role of gut microbiota and antibiotic use on immune checkpoint inhibitors efficacy. We aimed to evaluate the impact of early use of antibiotic (EUA), blood microbiome and plasmatic citrulline (marker of the intestinal barrier) on nivolumab efficacy in non-small cell lung cancer (NSCLC).METHODS: We included all consecutive patients with advanced NSCLC treated with nivolumab in our Department between 2014 and 2017. Blood microbiome was analyzed at month (M) M0 and M2. Citrulline rates were evaluated at M0, M2, M4 and M6.RESULTS: Seventy-two patients were included (EUA in 42%). Overall survival (OS) was longer without EUA (median 13.4months) than with EUA (5.1months, p=0.03). Thirty-five patients (49%) had plasma samples available. High citrulline rate (≥20muM) at M0 was associated with tumor response (p=0.084) and clinical benefit (nivolumab >6months) (p=0.002). Median progression-free survival (PFS) was 7.9months (high citrulline) vs 1.6months (low citrulline) (p