2024 World Conference on Lung Cancer (WCLC) - Posters-P2.11B.05 Effect of Dysbiosis-Inducing Drugs on the Response to Immune Checkpoint Inhibitors in Patients with NSCLC

P2.11B.05 Effect of Dysbiosis-Inducing Drugs on the Response to Immune Checkpoint Inhibitors in Patients with NSCLC

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This study investigates the impact of dysbiosis-inducing drugs on the efficacy of immune checkpoint inhibitors (ICIs) in patients with non-small cell lung cancer (NSCLC). ICIs have improved survival rates for these patients, but response rates are only 20-30%, necessitating better patient selection and biomarkers for treatment efficacy. The gut microbiota's composition is believed to correlate with ICI response, and certain drugs may disrupt this composition, affecting treatment results.<br /><br />The study, conducted at Strasbourg University Hospitals, analyzed the outcomes of patients treated with ICIs from 2015 to 2023. It focused on drugs known to alter gut microbiota, such as proton pump inhibitors (PPIs), opioids, and anti-H1 medications. The study included 705 patients who had been diagnosed with stage III-C/IV NSCLC, probing how these medications impacted overall survival (OS) and progression-free survival (PFS).<br /><br />Findings revealed that PPIs, opioids, and anti-H1 drugs were associated with poorer outcomes. PPIs were particularly detrimental, with significant reductions in OS and PFS. The proposed mechanism is that PPIs induce dysbiosis by altering gastric pH, which negatively affects gut bacteria, critical for modulating immune response. Opioids also led to reduced OS and showed a multifactorial impact on microbiota and immune cells. In a pioneering observation, anti-H1 drugs were found to adversely influence survival rates, although differences in group sizes warrant cautious interpretation.<br /><br />The study concludes that dysbiosis-inducing drugs, especially PPIs and opioids, impair the effectiveness of ICIs and worsen prognosis for NSCLC patients. Clinicians should carefully assess the necessity of these medications when planning immunotherapy to optimize treatment success and patient outcomes.

Asset Subtitle

Celine Mascaux

Meta Tag

Speaker Celine Mascaux

Topic Metastatic NSCLC – Immunotherapy

Keywords

dysbiosis-inducing drugs

immune checkpoint inhibitors

non-small cell lung cancer

gut microbiota

proton pump inhibitors

opioids

anti-H1 medications

overall survival

progression-free survival

treatment efficacy