Association of antibiotic exposure with the mortality in metastatic colorectal cancer patients treated with bevacizumab-containing chemotherapy: A hospital-based retrospective cohort study

English version

Autoři: Linbin Lu ^aff001; Tingting Zhuang ^aff001; Erqian Shao ^aff001; Yanhong Liu ^aff001; Huimin He ^aff001; Zhimin Shu ^aff001; Yan Huang ^aff001; Yichen Yao ^aff001; Shan Lin ^aff002; Shaoqin Lin ^aff001; Xi Chen ^aff001; Xiong Chen ^aff001
Působiště autorů: Department of Oncology, Fuzhou General Hospital of Nanjing Military Command, Fuzong Clinical College of Fujian Medical University, Fuzhou, Fujian, PR China ^aff001; Department of Neurology, Fuzhou General Hospital of Nanjing Military Command, Fuzhou, Fujian, PR China ^aff002
Vyšlo v časopise: PLoS ONE 14(9)
Kategorie: Research Article
prolekare.web.journal.doi_sk: https://doi.org/10.1371/journal.pone.0221964

Souhrn

Background

Preclinical studies showed that antibiotic exposure played a role in clinical outcomes in patients with chemotherapy via modulation of microbiota. However, it remains unknown whether antibiotic exposure during the bevacizumab therapy affects the clinical outcomes in metastatic colorectal cancer(mCRC) patients. This study aimed to examine the association between the antibiotic medication and the clinical outcomes in mCRC patients with bevacizumab therapy.

Methods

This retrospective cohort analysis included 147 mCRC patients treated with bevacizumab. The hazard ratio of death was estimated using three Cox proportional hazards models with (1) never vs ever; (2) never vs 1–6 days and 7–40 days;(3) increase per day, and further tested using propensity score matching (PSM) and landmark analysis. A smooth curve technique was used to explore the shape of dose-response relationship.

Results

Compared with the non-antibiotic group, antibiotic exposure was inversely associated with the mortality in the antibiotic group after adjustment for demographic and other potential confounders (a history of medication: HR, 0.650(95%CI: 0.360 to 1.173); an increase per day: HR, 0.967(CI: 0.924 to 1.011); 1–6 days: HR, 0.859(CI: 0.441 to 1.674); 7–40 days: HR, 0.474(CI: 0.225 to 0.999); P for trend = 0.040). A test for the interaction between sex was statistically significant (p = 0.016). A similar result was found as measured by landmark and PSM analysis. Significant negative dose-response relationship was shown by smooth curve analysis in the male patients but not female after adjustment for confounders(p = 0.028). No association was found between the antibiotic medication and adverse events of bevacizumab.

Conclusion

Antibiotic exposure could be inversely associated with the mortality in mCRC patients treated with bevacizumab.

Klíčová slova:

Biology and life sciences – Research and analysis methods – Animal studies – Experimental organism systems – Model organisms – Animal models – Medicine and health sciences – Microbiology – Pharmacology – Research design – Clinical medicine – Pharmaceutics – Drug therapy – Oncology – Cancer treatment – Cancers and neoplasms – Microbial control – Antimicrobials – Antibiotics – Drugs – Clinical research design – Adverse events – Vascular medicine – Mouse models – Blood pressure – Hypertension – Colorectal cancer – Cancer chemotherapy – Clinical oncology – Chemotherapy

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