抗生素对非小细胞肺癌免疫治疗疗效影响的Meta分析

Efficacy of antibiotics on the outcomes of patients with non-small cell lung cancer treated with immune checkpoint inhibitors: a meta-analysis

目的系统评价抗生素对非小细胞肺癌免疫治疗疗效的影响。方法计算机检索PubMed、EMbase、Web of Science、The Cochrane Library、CNKI、WanFang Data、VIP和CBM数据库,搜集抗生素对非小细胞肺癌免疫治疗疗效影响的队列研究,检索时限均为建库至2021年8月1日。由2名研究者独立筛选文献、提取资料并评价纳入研究的偏倚风险后,采用RevMan 5.3软件进行Meta分析。结果共纳入27个队列研究,包括7087例患者。Meta分析结果显示,未使用抗生素的患者具有较长的总体生存期(OS)[HR=2.04,95%CI(1.68,2.49),P<0.00001]和无进展生存期(PFS)[HR=1.63,95%CI(1.35,1.99),P<0.00001]。结论当前证据表明,使用抗生素可能会缩短非小细胞肺癌免疫治疗患者的OS和PFS。受纳入研究数量和质量的限制,上述结论尚待更多高质量研究予以验证。

Objective To systematically review the efficacy of antibiotics on the outcomes of patients with non-small cell lung cancer(NSCLC)treated with immune checkpoint inhibitors.Methods PubMed,EMbase,Web of Science,The Cochrane Library,CNKI,WanFang Data,VIP and CBM databases were electronically searched to collect cohort studies on efficacy of antibiotics on the outcomes of patients with NSCLC treated with immune checkpoint inhibitors from inception to August 1st,2021.Two reviewers independently screened literature,extracted data,and evaluated the risk of bias of the included studies.Meta-analysis was then performed by using RevMan 5.3 software.Results A total of 27 cohort studies involving 7087 patients were included.The results of meta-analysis showed that antibiotic use was associated with poor overall survival(OS)(HR=2.04,95%CI 1.68 to 2.49,P<0.00001)and progression free survival(PFS)(HR=1.63,95%CI 1.35 to 1.99,P<0.00001).Conclusion Current evidence shows that antibiotic use is associated with poor OS and PFS.Due to the limited quality and quantity of the included studies,more high-quality studies are needed to verify the above conclusion.