Antibiotic Use and Immune Checkpoint Inhibition in Head and Neck Squamous Cell Carcinoma.
retrospective_cohort · Level III
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- Record sourced from PubMed, PMID 42458796.
- Also identified by DOI 10.1002/hed.70392.
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Abstract
The clinical relevance of antibiotic exposure on immune checkpoint inhibitor (ICI) efficacy in head and neck squamous cell carcinoma (HNSCC) is not well characterized. This retrospective study included patients with recurrent/metastatic HNSCC treated between 2015 and 2025. Cox proportional hazards and Kaplan-Meier method modeled overall survival (OS). Of 316 patients (median age 68 years, 70.9% male), primary tumor site was 40.5% oral cavity, 34.8% oropharynx, 14.9% sinonasal/nasopharynx, 9.8% hypopharynx/larynx. One hundred and forty-eight (46.8%) patients received antibiotics surrounding ICI. Antibiotics were associated with decreased OS (HR = 1.53, 95% CI 1.15-2.04). On multivariable analysis, while intravenous route of administration and spectrum of antibiotic activity were not risk factors, oral cavity site (HR = 1.72, 95% CI 1.07-2.76), ECOG 2-4 (HR = 2.78, 95% CI 1.70-3.67), PD-L1 CPS < 1 (HR = 3.16, 95% CI 1.79-5.04), and number of antibiotic classes (HR = 1.37, 95% CI 1.18-1.59) independently predicted decreased OS. Antibiotic exposure was associated with decreased survival in HNSCC treated with ICI; however, future studies are needed to evaluate potential mechanistic etiologies underlying this association.