抗菌药物对PD-1/PD-L1抗体免疫治疗有效性影响的研究

Discussion on the effect of antibiotics on the effectiveness of PD-1/PD-L1 antibody immunotherapy

目的为恶性肿瘤患者在使用免疫检查点抑制剂(Immune checkpoint inhibitors,ICI)期间,合理选用临床抗菌药物方案及改善ICI治疗临床结局策略上提供参考。方法检索CNKI、万方、PubMed、Web of Science等数据库的国内外文献,对使用免疫检查点抑制剂期间使用抗菌药物的临床研究,进行整理分析。结果抗菌药物的使用会影响肠道微生物群,改变其代谢能力,降低ICI疗效。免疫治疗期间抗菌药物种类、给药时机、给药疗程及给药途径均可影响PD-1/PD-L1等免疫治疗疗效。结论对于正在接受ICI治疗的患者,需关注抗菌药物等伴随用药对ICI治疗疗效的影响,优化其治疗反应并尽量限制非有益药物的暴露,对晚期肿瘤患者免疫治疗的管理至关重要。

Objective To provide some references for rational selection of clinical antimicrobial regimens and strategies to improve the clinical outcomes of immune checkpoint inhibitors(ICI)in patients with malignant tumors during the use of ICI.Methods Domestic and foreign literatures were searched for in databases such as CNKI,Wanfang,PubMed,Web of Science,etc.,and the clinical research on antimicrobial drugs used during the use of immune checkpoint inhibitors was sorted out and analyzed.Results The use of antibiotics affected the intestinal microbial community,changed its metabolic capacity,and reduced the efficacy of ICI.During immunotherapy,the types of antibiotics,the timing of administration,the course of administration and the way of administration all had an impact on the efficacy of immunotherapy such as PD-1/PD-L1.Conclusion Patients are treated with ICI,antimicrobials that need to be focus on cancer patients with the effect of drugs for the treatment of ICI,optimizing treatment response and limit is good for the drug exposure,the management of patients with advanced tumor immunotherapy is crucial.