肠道微生物群在免疫反应中起着至关重要的作用。最近的数据显示，抗生素（ATB）的使用通过改变肠道菌群影响免疫核心抑制剂（ICI）的疗效。我们回顾性分析了在一个学术中心接受ICI单药治疗或化疗（ChT）联合治疗的晚期非小细胞肺癌（NSCLC）患者。将在ICI治疗开始的头12周内接受ATB的患者与未接受ATB的患者进行比较。本研究的主要目标是评估在ICI治疗期间ATB使用对总体生存率（OS）、无进展生存期（PFS）和客观响应率（ORR）的影响。我们分析了90名患者的数据。其中27名（30%）在治疗开始的头12周内接受了ATB。在接受了ICI治疗开始的头12周内接受ATB的患者中，PFS显著缩短（4.9个月对比24.8个月，HR 2.52，95% CI（1.52-4.18），p < 0.001）。OS也显著缩短（5.4个月对比37.8个月，HR 2.55，95% CI（1.48-4.40），p = 0.001）。我们还检查了ATB对ORR的影响。接受ATB的患者在前几周的治疗期间，其客观响应率持续恶化；ATB组的ORR为25.9%，无ATB组为55.6%（p = 0.01）。我们的发现表明，在NSCLC患者中，ICI开始时使用抗生素与OS、PFS和ORR的降低相关。这提示微生物多样性可能是预测ICI疗效的因素之一。版权所有 © 2023 作者。由Elsevier B.V.出版。保留所有权利。

Gut microbiotaplays a crucial role in immune response. Recent data have shown that antibiotic (ATB) usage influences efficacy of immune check point inhibitors (ICIs) via altering microbiota of the gut.We retrospectively analyzed patients with advanced non-small cell lung cancer (NSCLC) treated with ICIs as monotherapy or combination with chemotherapy (ChT) at the one academic center. Those receiving ATB for the first 12 weeks of the initiation of ICIs were compared with those who did not. The primary objective of this study was to assess the impact of ATB use on overall survival (OS), progression-free survival (PFS), and objective response rate (ORR) during ICIs therapy.90 patients were included in our analysis. Of these 90 patients, 27 (30%) received ATB in the first 12 weeks of the treatment. In patients who received ATB in the first 12 weeks of ICIs administration, PFS was significantly shorter (4.9 vs. 24.8 months, HR 2.52, 95% CI (1.52-4.18), p < 0.001). OS was also significantly shorter (5.4 vs. 37.8 months, HR 2.55, 95% CI (1.48-4.40), p = 0.001). We also examined the impact of ATB on ORR. Exposure to ATB for the first weeks consistently worsened the response rate; the ORR was 25.9% in the ATB group and 55.6% in the no ATB group (p = 0.01).Our findings demonstrated that the use of antibiotics around ICIs initiation was associated with decreased OS, PFS, and ORR in patients with NSCLC. This suggests that microbiota diversity may be one of the factors predicting the efficacy of ICIs.Copyright © 2023 The Author(s). Published by Elsevier B.V. All rights reserved.