晚期NSCLC患者的抗生素使用和存活率 晚期NSCLC患者用化学免疫疗法治疗
Emanuela Taioli1,2,3, Raja M Flores2, Arwa Abdelhamid1
1Institute for Translational Epidemiology, Icahn School of Medicine at Mount Sinai, New York, New York.
JTO clinical and research reports
|November 19, 2024
概括
在接受免疫治疗的高级非小细胞肺癌 (NSCLC) 患者中使用抗生素与较差的生存率有关. 多次抗生素疗程显著恶化了结果,即使是化疗免疫疗法.
科学领域:
- 在瘤学瘤学.
- 免疫治疗是一种免疫疗法.
- 微生物组研究 微生物组研究
背景情况:
- 免疫治疗改善了高级非小细胞肺癌 (NSCLC) 的存活率.
- 抗生素的使用可能会对免疫疗法的有效性产生负面影响,可能是通过肠道微生物组的破坏.
- 美国患者群体中这种相互作用的现实数据有限.
研究的目的:
- 分析抗生素使用与晚期NSCLC患者的存活率之间的关联.
- 调查抗生素时间和频率对治疗结果的影响.
- 在化疗和化疗免疫治疗的背景下评估这种关系.
主要方法:
- 追溯分析了788名在2015年被诊断为IV期NSCLC的患者.
- 使用了监测,流行病学和最终结果-医疗保险数据,持续覆盖A,B和D部分.
- 采用卡普兰-梅尔和考克斯的比例危险模型来评估生存结果.
主要成果:
- 56%的患者在开始全身治疗后2个月内接受了抗生素.
- 抗生素使用与更糟糕的生存率 (p=0.007) 有关.
- 多轮抗生素治疗显示出统计学上显著的相关性与更差的生存率 (aHR: 1.35,95% CI: 1.14-1.60),特别是在化疗免疫疗法小组中.
结论:
- 与化疗免疫治疗同时使用抗生素与晚期NSCLC的存活率下降有关.
- 对生存的负面影响在增加抗生素治疗周期时更加明显.
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