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Published on: April 22, 2019
Antibiotic Use and Immune Checkpoint Inhibition in Head and Neck Squamous Cell Carcinoma
Shannon S Wu1, Vasu Divi1, John B Sunwoo1
1Division of Head and Neck Surgery, Department of Otolaryngology-Head and Neck Surgery, Stanford University School of Medicine, Palo Alto, California, USA.
Head & Neck
|July 16, 2026
Summary
Antibiotic exposure negatively impacts survival for head and neck squamous cell carcinoma (HNSCC) patients receiving immune checkpoint inhibitors (ICI). Further research is needed to understand why antibiotics affect ICI efficacy in HNSCC treatment.
Area of Science:
- Oncology
- Immunotherapy
- Pharmacology
Background:
- The impact of antibiotic use on immune checkpoint inhibitor (ICI) effectiveness in head and neck squamous cell carcinoma (HNSCC) is not well understood.
- Investigating this relationship is crucial for optimizing cancer treatment strategies.
Purpose of the Study:
- To determine the association between antibiotic exposure and overall survival (OS) in patients with recurrent or metastatic HNSCC treated with ICI.
- To identify factors influencing survival outcomes in this patient population.
Main Methods:
- Retrospective analysis of 316 patients with recurrent/metastatic HNSCC treated between 2015 and 2025.
- Utilized Cox proportional hazards and Kaplan-Meier methods to model overall survival.
- Multivariable analysis identified independent predictors of decreased OS.
Main Results:
- Nearly half (46.8%) of patients received antibiotics around the time of ICI treatment.
- Antibiotic exposure was significantly associated with decreased OS (HR=1.53).
- Factors independently predicting decreased OS included oral cavity tumor site, higher ECOG scores, low PD-L1 expression, and multiple antibiotic classes.
Conclusions:
- Antibiotic exposure is linked to reduced survival in HNSCC patients undergoing ICI therapy.
- The underlying mechanisms for this association require further investigation.
- These findings highlight the importance of considering antibiotic use in HNSCC treatment protocols.
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