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Differential effects of prior versus concomitant steroid and antibiotic treatment on immunotherapy efficacy: a pooled analysis of the RAMONA, INTEGA, OPTIM, ELDORANDO, FORCE, TITAN-RCC and TITAN-TCC Trials of the German AIO Study Group

Background We explored the association of immune-related adverse events (irAE), along with prior and concomitant antibiotic and steroid use, on oncological outcomes following immune checkpoint inhibitor (ICI) treatment in various solid tumours. Methods Pooled data from seven trials on ICI therapy ac...

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Autori principali: Wiest, Isabella (Autore) , Dreikhausen, Lena (Autore) , Keller, Ralph (Autore) , Marin-Galiano, Marcos (Autore) , Albiges, Laurence (Autore) , Meran, Johannes (Autore) , Leucht, Katharina (Autore) , Rieken, Stefan (Autore) , Esteban, Emilio (Autore) , Zengerling, Friedemann H. (Autore) , Tintelnot, Joseph (Autore) , Grimm, Marc-Oliver (Autore) , Bozorgmehr, Farastuk (Autore) , Christopoulos, Petros (Autore) , Stein, Alexander (Autore) , Binder, Mascha (Autore) , Härtel, Nicolai (Autore) , Klinghammer, Konrad (Autore) , Grünwald, Viktor (Autore) , Pogorzelski, Michael (Autore) , Ebert, Matthias (Autore)
Natura: Article (Journal)
Lingua:inglese
Pubblicazione: 19 May 2026
In: British journal of cancer
Year: 2026, Pages: 1-9
ISSN:1532-1827
DOI:10.1038/s41416-026-03428-8
Accesso online:Verlag, kostenfrei, Volltext: https://doi.org/10.1038/s41416-026-03428-8
Verlag, kostenfrei, Volltext: https://www.nature.com/articles/s41416-026-03428-8
Testo
Note sull'autore:Isabella C. Wiest, Lena Dreikhausen, Ralph Keller, Marcos Marin-Galiano, Laurence Albiges, Johannes Meran, Katharina Leucht, Stefan Rieken, Emilio Esteban, Friedemann Zengerling, Joseph Tintelnot, Marc-Oliver Grimm, Farastuk Bozorgmehr, Petros Christopoulos, Alexander Stein, Mascha Binder, Nicolai Härtel, Konrad Klinghammer, Viktor Grünwald, Michael Pogorzelski and Matthias P. Ebert
Descrizione
Riassunto:Background We explored the association of immune-related adverse events (irAE), along with prior and concomitant antibiotic and steroid use, on oncological outcomes following immune checkpoint inhibitor (ICI) treatment in various solid tumours. Methods Pooled data from seven trials on ICI therapy across multiple cancer types (head and neck, non-small cell lung cancer, gastroesophageal junctional adenocarcinoma, oesophageal, renal cell, and urothelial carcinoma) was analysed, focusing on overall survival (OS) and progression-free survival (PFS) and antibiotic or steroid use before and during the study. Results Of 693 patients, 80 used steroids and 52 used antibiotics prior to the study, while 360 and 331, respectively, used them concomitantly. Lack of prior antibiotic use was associated with longer OS (No vs. Yes: HR 0.552, 95%-CI 0.370–0.822, p = 0.0035) and PFS (No vs. Yes: HR 0.703, 95%-CI 0.485–1.019, p = 0.0625), whereas concomitant antibiotic use had no such effect. Patients with concomitant steroid use demonstrated longer PFS (No vs. Yes: HR 1.359, 95%-CI 1.091–1.693, p = 0.0061). Discussion Our study confirmed associations between antibiotic and steroid use and ICI efficacy in cancer. Prior, but not concomitant, antibiotic use was linked to reduced OS, supporting the role of microbiome diversity in tumour response. Concomitant steroid use was associated with improved PFS, potentially reflecting its link to irAE occurrence.
Descrizione del documento:Gesehen am 18.06.2026
Descrizione fisica:Online Resource
ISSN:1532-1827
DOI:10.1038/s41416-026-03428-8

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