Shilpa Gupta, MD, Cleveland Clinical, Ohio, discusses a retrospective analysis that evaluated the effect of antibiotic use within 30 days of initiation of immune checkpoint inhibitors on overall survival among patients with metastatic urothelial carcinoma in real-world practice.

The results of this study were presented at the virtual 2021 ASCO Genitourinary Cancers Symposium.

Transcript

Hello, I am Dr. Shilpa Gupta. I am a genitourinary oncologist at the Cleveland Clinic. I'll be discussing our abstract presented at the ASCO GU 2021 in which we studied the effect of antibiotic use within 30 days of initiation of immune checkpoint inhibitors on efficacy in patients with metastatic urothelial cancer in the real-world setting and our single institutional cohort at Cleveland Clinic.

We know that antibiotic use affects gut microbiome. Some reports suggest negative outcomes with immunotherapy in solid tumors, including metastatic urothelial cancer.

We previously showed that antibiotic use within 60 days of immune checkpoint inhibitor initiation in metastatic urothelial cancer did not impact progression-free survival.

Now we wanted to look at correlation with the timing of 30 days within use of immune checkpoint inhibitor initiation. This is a retrospective analysis in adult patients with metastatic urothelial cancer who are treated at Cleveland Clinic between 2015 and 2020.

Patients received at least 2 cycles of immunotherapy: atezolizumab or pembrolizumab. The statistical analysis included overall survival using logrank test, Fisher's exact test, and Kruskal-Wallis test as applicable.

We had a cohort of around the 115 patients. We did not see any correlation of antibiotic use with overall survival in our cohort within 30 days of immune checkpoint inhibitor initiation.

This is important data as there's really no prospective data available on whether antibiotics affect the efficacy of immune checkpoint inhibitors in metastatic urothelial cancer and larger prospective studies are needed to further elucidate this correlation.

Thank you.

Gupta S, Kahn MS, Radakovich N. The effect of antibiotic use within 30 days of initiation of immune checkpoint inhibitor (ICI) efficacy in patients with metastatic urothelial carcinoma (mUC) in real-world setting. Presented at: the virtual 2021 ASCO Genitourinary Cancers Symposium; February 11-13, 2021. Abstract 417.

Dr Gupta reports no relevant financial relationships.