Advertisement

Efficacy of immunotherapy, gut microbiota and impact of antibiotic use: are there confounding factors?

  • G. MilanoEmail author
Letter to the Editor

The inter-relationship between host microbiota and immunotherapy by checkpoint inhibitors (CPI) is currently actively investigated at experimental, pre-clinical and clinical levels [1]. It has recently been shown that tumor expression of chemokines associated with T-cell infiltration can be stimulated by gut bacteria, and reduced by antibiotic treatment [2]. Antibiotics may impair gut microbiota and their use is logically suspected to have a deleterious impact on the clinical outcome of patients treated with immune checkpoint inhibitors [2]. There is by consequence a current view bridging antibiotic use, impaired gut microbiota and subsequently negative impact on immune checkpoint inhibitors efficacy which stimulates clinical investigations [3]. Specific clinical studies indicate a poor clinical benefit in patients undergoing immunotherapy with a history of previous antibiotic use [4].

However, it must be kept in mind the clinical context where antibiotics are often administrated...

Notes

Compliance with ethical standards

Conflict of interest

The author declares no conflict of interest.

Ethical standards

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

References

  1. 1.
    Gopalakrishnan V et al (2018) The influence of the gut microbiome on cancer, immunity, and cancer immunotherapy. Cancer Cell 33:570–580CrossRefGoogle Scholar
  2. 2.
    Cremonesi E, Governa V, Garzon JFG et al (2018) Gut microbiota modulate T cell trafficking into human colorectal cancer. Gut 67:1984–1994CrossRefGoogle Scholar
  3. 3.
    Routy B, Le Chatelier E, Derosa L et al (2018) Gut microbiome influences efficacy of PD-1-based immunotherapy against epithelial tumors. Science 359:91–97CrossRefGoogle Scholar
  4. 4.
    Derosa L, Hellmann MD, Spaziano M (2018) Negative association of antibiotics on clinical activity of immune checkpoint inhibitors in patients with advanced renal cell and non-small-cell lung cancer. Ann Oncol 29:1437–1444CrossRefGoogle Scholar
  5. 5.
    Keiser RJ, Huitema ADR, Schellens JMH, Beijnen JH (2010) Clinical pharmacokinetics of therapeutic monoclonal antibodies. Clin Pharmacokinet 49:493–507CrossRefGoogle Scholar
  6. 6.
    Ternant D, Azzopardi N, Raoul W et al (2018) Influence of antigen mass on the pharmacokinetics of therapeutic antibodies in humans. Clin Pharmacokinet 58(2):169–187.  https://doi.org/10.1007/s40262-018-0680-3 CrossRefGoogle Scholar
  7. 7.
    Feng Y, Wang X, Bajaj C et al (2017) Nivolumab exposure-response analyses of efficacy and safety in previously treated squamous or non-squamous non-small cell lung cancer. Clin Cancer Res 23:5394–5405CrossRefGoogle Scholar
  8. 8.
    Nenu I, Gafencu GA, Popescu T, Kacso G (2017) Lactate—a new frontier in the immunology and therapy of prostate cancer. J Cancer Res Ther 13:406–411Google Scholar
  9. 9.
    Zimmermann M, Zimmermann-Kogadeeva M, Wegmann R, Goodman AL (2019) Separating host and microbiome contributions to drug pharmacokinetics and toxicity. Science 363:1.  https://doi.org/10.1126/science.aat9931 CrossRefGoogle Scholar
  10. 10.
    Casanovas Blanco M (2018) Critical review of emergency department management of chemotherapy complications in cancer patients. Eur J Cancer Care 28(2):e12974.  https://doi.org/10.1111/ecc.12974 CrossRefGoogle Scholar

Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Oncopharmacology UnitCentre Antoine Lacassagne and EA 3836 Nice UniversityNice Cedex 2France

Personalised recommendations