Antibiotic use is a negative predictor of the efficacy and toxicity of epidermal growth factor receptor‑targeted therapy in advanced non‑small cell lung cancer

Liu,Kejun; Zhang,Weiwei; Tan,Qinquan; Jiang,Guanming; Jia,Jun

doi:10.3892/ol.2019.10481

Antibiotic use is a negative predictor of the efficacy and toxicity of epidermal growth factor receptor‑targeted therapy in advanced non‑small cell lung cancer

Authors:
- Kejun Liu
- Weiwei Zhang
- Qinquan Tan
- Guanming Jiang
- Jun Jia
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Affiliations: Department of Oncology, Dongguan Institute for Clinical Cancer Research, Dongguan People's Hospital, Southern Medical University, Dongguan, Guangdong 523059, P.R. China, Department of Oncology, The Fifth People's Hospital of Chengdu, Chengdu, Sichuan 611130, P.R. China
Published online on: June 14, 2019 https://doi.org/10.3892/ol.2019.10481
Pages: 2677-2683
Copyright: © Liu et al. This is an open access article distributed under the terms of Creative Commons Attribution License.

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Abstract

Non‑small cell lung cancer (NSCLC) is closely associated with inflammation and chronic infection. Antibiotics are frequently prescribed for NSCLC patients in combination with epidermal growth factor receptor (EGFR)‑targeted treatment in the presence of infection. The association between antibiotic use and the efficacy of EGFR tyrosine kinase inhibitors (EGFR‑TKIs) has not previously been thoroughly investigated. Therefore, the present study investigated whether antibiotics could affect the efficacy and toxicity of EGFR‑TKI treatment, with the aim of restricting the use of antibiotics in combination with targeted therapy in patients with advanced NSCLC in the near future. All patients received treatment with EGFR‑TKIs until disease progression, unacceptable toxicity or other factors, including death, pregnancy or unwillingness to further receive targeted therapy, were observed. Patients were retrospectively divided into two groups: Group A, which was treated with EGFR‑TKIs and antibiotics; and Group B, which was treated with EGFR‑TKIs alone. Patients having used antibiotics 6 months prior to EGFR‑TKI therapy were also included in the study. Antibiotic use negatively affected the median progression‑free survival (PFS) following EGFR‑TKI treatment in NSCLC compared with that in patients not treated with antibiotics; median PFS in Group A was 6.6 months, whereas median PFS in Group B was 10.1 months. Antibiotics also increased the toxicity of targeted therapy for advanced NSCLC. There were significant statistical differences between the two groups in the occurrence of the adverse events of diarrhea and dyspnea. In conclusion, antibiotics decreased the efficacy of first‑line targeted therapy in advanced NSCLC and increased incidences of diarrhea and dyspnea. Large randomized studies are needed to identify the impact of antibiotic use on EGFR‑TKI treatment for NSCLC.

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