Abstract
Background
Antibiotics (ATBs) induce dysbiosis of the gut microbiota by altering the diversity and composition of the microbiota, which mediates the efficacy and toxicity of cancer therapy. The influence of dysbiosis induced by ATB administration on primary resistance to chemotherapy in patients with advanced gastric cancer (GC) has rarely studied. We evaluated the effect of ATB administration on chemotherapy efficacy in patients with advanced GC.
Methods
Patients with GC were divided into two groups according to the statues of ATB administration: ATB-treated and control groups. Tumor responses, progression-free survival (PFS), and overall survival (OS) were assessed.
Results
We found that the incidence of progressive disease in the ATB-treated group was significantly higher when compared with that in the control group that received no ATB treatment (72.73% vs. 29.55%, p = 0.007). In addition, ATB administration was associated with shorter PFS [median PFS: 1.47 vs. 4.97 months, hazard ratio (HR): 2.296, 95% confidence interval (CI): 1.214–4.342, p = 0.011] and reduced OS (median OS: 9.97 vs. 13.3 months, HR: 2.101, 95% CI: 1.030–4.286, p = 0.041) based on univariate analysis. Subsequent multivariate analysis also indicated that ATB administration was an independent prognostic factor for PFS (HR: 3.361, 95% CI: 1.592–7.097, p = 0.001) and OS (HR: 2.280, 95% CI: 1.042–4.991, p = 0.039).
Conclusions
ATB administration is associated with reduced chemotherapy efficacy and poor prognosis in patients with advanced GC. Modulations in ATB-related dysbiosis and gut microbiota composition improve the clinical outcomes of chemotherapy.
Erratum to: Apoptosis index correlates with chemotherapy efficacy and predicts the survival of patients with gastric cancer
