Antibiotic use influences outcomes in advanced pancreatic adenocarcinoma patients
Abstract Recent studies defined a potentially important role of the microbiome in modulating pancreatic ductal adenocarcinoma (PDAC) and responses to therapies. We hypothesized that antibiotic usage may predict outcomes in patients with PDAC. We retrospectively analyzed clinical data of patients wit...
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Wiley
2021-08-01
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Series: | Cancer Medicine |
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Online Access: | https://doi.org/10.1002/cam4.3870 |
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Article |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Chirayu Mohindroo Merve Hasanov Jane E. Rogers Wenli Dong Laura R. Prakash Seyda Baydogan Jonathan D. Mizrahi Michael J. Overman Gauri R. Varadhachary Robert A. Wolff Milind M. Javle David R. Fogelman Michael T. Lotze Michael P. Kim Matthew H.G. Katz Shubham Pant Ching‐Wei D. Tzeng Florencia McAllister |
spellingShingle |
Chirayu Mohindroo Merve Hasanov Jane E. Rogers Wenli Dong Laura R. Prakash Seyda Baydogan Jonathan D. Mizrahi Michael J. Overman Gauri R. Varadhachary Robert A. Wolff Milind M. Javle David R. Fogelman Michael T. Lotze Michael P. Kim Matthew H.G. Katz Shubham Pant Ching‐Wei D. Tzeng Florencia McAllister Antibiotic use influences outcomes in advanced pancreatic adenocarcinoma patients Cancer Medicine antibiotics autophagy chemotherapeutic agents immunity microbiota pancreatic adenocarcinoma |
author_facet |
Chirayu Mohindroo Merve Hasanov Jane E. Rogers Wenli Dong Laura R. Prakash Seyda Baydogan Jonathan D. Mizrahi Michael J. Overman Gauri R. Varadhachary Robert A. Wolff Milind M. Javle David R. Fogelman Michael T. Lotze Michael P. Kim Matthew H.G. Katz Shubham Pant Ching‐Wei D. Tzeng Florencia McAllister |
author_sort |
Chirayu Mohindroo |
title |
Antibiotic use influences outcomes in advanced pancreatic adenocarcinoma patients |
title_short |
Antibiotic use influences outcomes in advanced pancreatic adenocarcinoma patients |
title_full |
Antibiotic use influences outcomes in advanced pancreatic adenocarcinoma patients |
title_fullStr |
Antibiotic use influences outcomes in advanced pancreatic adenocarcinoma patients |
title_full_unstemmed |
Antibiotic use influences outcomes in advanced pancreatic adenocarcinoma patients |
title_sort |
antibiotic use influences outcomes in advanced pancreatic adenocarcinoma patients |
publisher |
Wiley |
series |
Cancer Medicine |
issn |
2045-7634 |
publishDate |
2021-08-01 |
description |
Abstract Recent studies defined a potentially important role of the microbiome in modulating pancreatic ductal adenocarcinoma (PDAC) and responses to therapies. We hypothesized that antibiotic usage may predict outcomes in patients with PDAC. We retrospectively analyzed clinical data of patients with resectable or metastatic PDAC seen at MD Anderson Cancer from 2003 to 2017. Demographic, chemotherapy regimen and antibiotic use, duration, type, and reason for indication were recorded. A total of 580 patients with PDAC were studied, 342 resected and 238 metastatic patients, selected retrospectively from our database. Antibiotic use, for longer than 48 hrs, was detected in 209 resected patients (61%) and 195 metastatic ones (62%). On resectable patients, we did not find differences in overall survival (OS) or progression‐free survival (PFS), based on antibiotic intake. However, in the metastatic cohort, antibiotic consumption was associated with a significantly longer OS (13.3 months vs. 9.0 months, HR 0.48, 95% CI 0.34–0.7, p = 0.0001) and PFS (4.4 months vs. 2 months, HR 0.48, 95% CI 0.34–0.68, p = <0.0001). In multivariate analysis, the impact of ATB remained significant for PFS (HR 0.59, p = 0.005) and borderline statistically significant for OS (HR 0.69, p = 0.06). When we analyzed by chemotherapy regimen, we found that patients who received gemcitabine‐based chemotherapy as first‐line therapy (n = 118) had significantly prolonged OS (HR 0.4, p 0.0013) and PFS (HR 0.55, p 0.02) if they received antibiotics, while those receiving 5FU‐based chemotherapy (n = 98) had only prolonged PFS (HR 0.54, p = 0.03). Antibiotics‐associated modulation of the microbiome is associated with better outcomes in patients with metastatic PDAC. |
topic |
antibiotics autophagy chemotherapeutic agents immunity microbiota pancreatic adenocarcinoma |
url |
https://doi.org/10.1002/cam4.3870 |
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doaj-0a9f7dec3b6a427caf5cf0242b007a102021-08-04T10:21:23ZengWileyCancer Medicine2045-76342021-08-0110155041505010.1002/cam4.3870Antibiotic use influences outcomes in advanced pancreatic adenocarcinoma patientsChirayu Mohindroo0Merve Hasanov1Jane E. Rogers2Wenli Dong3Laura R. Prakash4Seyda Baydogan5Jonathan D. Mizrahi6Michael J. Overman7Gauri R. Varadhachary8Robert A. Wolff9Milind M. Javle10David R. Fogelman11Michael T. Lotze12Michael P. Kim13Matthew H.G. Katz14Shubham Pant15Ching‐Wei D. Tzeng16Florencia McAllister17Department of Clinical Cancer Prevention The University of Texas MD Anderson Cancer Center Houston Texas USADepartment of Clinical Cancer Prevention The University of Texas MD Anderson Cancer Center Houston Texas USAPharmacy Clinical Programs The University of Texas MD Anderson Cancer Center Houston Texas USADepartment of Biostatistics The University of Texas MD Anderson Cancer Center Houston Texas USADepartment of Surgical Oncology The University of Texas MD Anderson Cancer Center Houston Texas USADepartment of Clinical Cancer Prevention The University of Texas MD Anderson Cancer Center Houston Texas USADepartment of Cancer Medicine The University of Texas MD Anderson Cancer Center Houston Texas USADepartment of Gastrointestinal Medical Oncology The University of Texas MD Anderson Cancer Center Houston Texas USADepartment of Gastrointestinal Medical Oncology The University of Texas MD Anderson Cancer Center Houston Texas USADepartment of Gastrointestinal Medical Oncology The University of Texas MD Anderson Cancer Center Houston Texas USADepartment of Gastrointestinal Medical Oncology The University of Texas MD Anderson Cancer Center Houston Texas USADepartment of Gastrointestinal Medical Oncology The University of Texas MD Anderson Cancer Center Houston Texas USADepartment of Surgery University of Pittsburgh Medical Center Pittsburgh Pennsylvania USADepartment of Surgical Oncology The University of Texas MD Anderson Cancer Center Houston Texas USADepartment of Surgical Oncology The University of Texas MD Anderson Cancer Center Houston Texas USADepartment of Gastrointestinal Medical Oncology The University of Texas MD Anderson Cancer Center Houston Texas USADepartment of Surgical Oncology The University of Texas MD Anderson Cancer Center Houston Texas USADepartment of Clinical Cancer Prevention The University of Texas MD Anderson Cancer Center Houston Texas USAAbstract Recent studies defined a potentially important role of the microbiome in modulating pancreatic ductal adenocarcinoma (PDAC) and responses to therapies. We hypothesized that antibiotic usage may predict outcomes in patients with PDAC. We retrospectively analyzed clinical data of patients with resectable or metastatic PDAC seen at MD Anderson Cancer from 2003 to 2017. Demographic, chemotherapy regimen and antibiotic use, duration, type, and reason for indication were recorded. A total of 580 patients with PDAC were studied, 342 resected and 238 metastatic patients, selected retrospectively from our database. Antibiotic use, for longer than 48 hrs, was detected in 209 resected patients (61%) and 195 metastatic ones (62%). On resectable patients, we did not find differences in overall survival (OS) or progression‐free survival (PFS), based on antibiotic intake. However, in the metastatic cohort, antibiotic consumption was associated with a significantly longer OS (13.3 months vs. 9.0 months, HR 0.48, 95% CI 0.34–0.7, p = 0.0001) and PFS (4.4 months vs. 2 months, HR 0.48, 95% CI 0.34–0.68, p = <0.0001). In multivariate analysis, the impact of ATB remained significant for PFS (HR 0.59, p = 0.005) and borderline statistically significant for OS (HR 0.69, p = 0.06). When we analyzed by chemotherapy regimen, we found that patients who received gemcitabine‐based chemotherapy as first‐line therapy (n = 118) had significantly prolonged OS (HR 0.4, p 0.0013) and PFS (HR 0.55, p 0.02) if they received antibiotics, while those receiving 5FU‐based chemotherapy (n = 98) had only prolonged PFS (HR 0.54, p = 0.03). Antibiotics‐associated modulation of the microbiome is associated with better outcomes in patients with metastatic PDAC.https://doi.org/10.1002/cam4.3870antibioticsautophagychemotherapeutic agentsimmunitymicrobiotapancreatic adenocarcinoma |