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Attend this session at the
2018 ASCO Annual Meeting!


Session: Developmental Therapeutics—Immunotherapy

Type: Poster Session

Time: Monday June 4, 8:00 AM to 11:30 AM

Location: Hall A


Session: Developmental Therapeutics—Immunotherapy

Type: Poster Discussion Session

Time: Monday June 4, 11:30 AM to 12:45 PM

Location: Hall B1

Cumulative antibiotic use and efficacy of immune checkpoint inhibitors in patients with advanced cancer.

Sub-category:
Immune Checkpoint Inhibitors

Category:
Developmental Therapeutics—Immunotherapy

Meeting:
2018 ASCO Annual Meeting

Abstract No:
3010

Poster Board Number:
Poster Discussion Session (Board #224)

Citation:
J Clin Oncol 36, 2018 (suppl; abstr 3010)

Author(s): Nadina Tinsley, Cong Zhou, Shaun Villa, Grace Tan, Paul Lorigan, Fiona Helen Blackhall, Tony Elliott, Matthew Krebs, Louise Carter, Fiona Thistlethwaite, Andrew Hughes, Natalie Cook; Christie Hospital, Manchester, United Kingdom; Paterson Institute for Cancer Research, Manchester, United Kingdom; The Christie NHS Foundation Trust, Manchester, United Kingdom; University of Manchester, Manchester, United Kingdom; University of Manchester and the Christie NHS Foundation Trust, Manchester, United Kingdom; The University of Manchester, Institute of Cancer Sciences, Manchester, United Kingdom; Christie Hospital NHS Foundation Trust, Manchester, United Kingdom; The Christie NHS Foundation Trust and The University of Manchester, Manchester Academic Health Sciences Centre, Manchester, United Kingdom; Experimental Cancer Medicine Team, The Christie NHS Foundation Trust, Manchester, United Kingdom; The Christie NHS Foundation Trust and University of Manchester, Manchester, United Kingdom

Abstract Disclosures

Abstract:

Background: Efficacy of immune checkpoint inhibitors (CKIs) for treatment of cancer may be affected by the use of antibiotics (ABX). The gut microbiome is involved in immunotherapy responses therefore ABX known to alter the gut microbiome may affect tumour inflammation and microenvironment, leading to decreased CKI efficacy. Methods: Retrospective data analysis was undertaken on metastatic cancer patients (pts) treated with CKIs between January 2015 and March 2017 at the Christie NHS Foundation Trust. Melanoma, renal and non-small cell lung cancer (NSCLC) pts were included. Demographics, prior systemic treatment, extent of disease, CKI agent and use of ABX (route, duration, multiple concurrent/successive courses) were collected. Progression free survival (PFS) and overall survival (OS) were compared between ABX groups (ABX + defined as pts treated with ABX within 2 weeks of CKI initiation or 6 weeks after, ABX as pts with no ABX during specified period). Statistical analyses were performed with univariate and multivariate models. Results: Of 303 included pts (201 (66%) melanoma, 56 (18%) NSCLC and 46 (15%) renal) 94 (31%) received ABX (commonest beta-lactam ABX and macrolides). In multivariate analysis, ABX + pts had shorter PFS and OS when compared to ABX pts: PFS 97 days (95% CI 84-122) vs 178 days (95% CI 155-304) p = 0.049; OS 317 days (95% CI 221-584) vs 651 days (95% CI 477-998) p = 0.001. Cumulative ABX ( > 10 days, multiple concurrent/successive courses) demonstrated particularly shortened PFS 87 days (95% CI 83-122) p = 0.0093 and OS 193 days (95% CI 96-355) p = 0.00021. Pts treated with ABX prior to CKI initiation had shorter PFS and OS than those treated after CKI initiation (HR 1.37 and HR 1.72) p = 0.29 and 0.08 respectively. Conclusions: To our knowledge, this is the largest multivariate analysis showing ABX use is an independent predictor of shorter PFS and OS in cancer pts treated with CKI. It is the first analysis to demonstrate cumulative ABX use is associated with even poorer outcomes across multiple tumour types independent of clinical factors. The data suggests a trend towards reduced PFS in pts who received ABX prior to CKI initiation, warranting further validation in a larger cohort.

 
Other Abstracts in this Sub-Category:

 

1. ICONIC: Biologic and clinical activity of first in class ICOS agonist antibody JTX-2011 +/- nivolumab (nivo) in patients (pts) with advanced cancers.

Meeting: 2018 ASCO Annual Meeting Abstract No: 3000 First Author: Timothy Anthony Yap
Category: Developmental Therapeutics—Immunotherapy - Immune Checkpoint Inhibitors

 

2. Anti-CD27 agonist antibody varlilumab (varli) with nivolumab (nivo) for colorectal (CRC) and ovarian (OVA) cancer: Phase (Ph) 1/2 clinical trial results.

Meeting: 2018 ASCO Annual Meeting Abstract No: 3001 First Author: Rachel E. Sanborn
Category: Developmental Therapeutics—Immunotherapy - Immune Checkpoint Inhibitors

 

3. NKTR-214 (CD122-biased agonist) plus nivolumab in patients with advanced solid tumors: Preliminary phase 1/2 results of PIVOT.

Meeting: 2018 ASCO Annual Meeting Abstract No: 3006 First Author: Adi Diab
Category: Developmental Therapeutics—Immunotherapy - Immune Checkpoint Inhibitors

 

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