Table 1.
Characteristics of included studies.
| Author/ Year |
Type of Study | N° Of Patients (Disease) |
Treatment Received (%) | Median Age (Years) | Ab% /Timing |
Median Duration (Weeks)/n° of AB Courses/pts | Med FUP (mos) |
Type of Analysis | Covariates of MVA for OS |
Quality (NOS Score) |
|---|---|---|---|---|---|---|---|---|---|---|
| Abu-Sbeih/ 2019 |
retrospective | 826 (melanoma n = 347; hematologic n = 116; other n = 363) | anti-PD(L)1 (51.6), anti-CTLA4 (32), combo (16.5) | 62 | 68.9 /before or after start (47.5%), both (52.5%) |
NR/NR | NR | MVA | ICI type, Stage IV cancer, IMDC, anaerobic AB use |
6 |
| Ahmed/ 2018 |
retrospective | 60 (NSCLC n = 34; other n = 26) | anti-PD1 (81.7), anti-PDL1 (5), ICI + CT (13.3) |
59 | 28 /2w before and/or after start |
1–2 | NR | MVA | broad spectrum AB use, age | 5 |
| Derosa/ 2018 |
retrospective | 360 (RCC n = 121, NSCLC n = 239) | RCC: anti-PD(L)1 (88), anti-PD(L)1 + anti-CTLA4 (8), anti-PD(L)1 + BEVA (4) NSCLC: anti-PD(L)1 (86), combo (14) |
64 | 21.5 /1 mos before start |
NR/NR | NR | MVA | RCC: ab 30–0 days/no AB IMDC risk, tumour burden NSCLC: ab 30–0 days/no AB, PS, clinical trial Y/N, prior regimens >/<3 |
5 |
| Elkrief/ 2019 |
retrospective | 59 (melanoma) * | NIVO/PEMBRO/IPI (100) | 64.5 | 13.5° /1 month before |
0.9/NR | NR | MVA | age, PS, gender, AB use, LDH, BRAF, line of tx, type of ICI | 5 |
| Galli/ 2019 |
retrospective | 157 (NSCLC) | anti-PD(L)1 (95.6), anti-CTLA4 o combo (4.4) | 66.7 | 17.2 /during ICI period |
1/NR | 28.6 | MVA | high AB /immunotherapy exposure ratio through entire ICI period | 8 |
| Guo/ 2019 |
retrospective | 49 (oesophageal) | anti-PD(L1) alone (61), combo (39) | 56.7 | 43/2 mos before or 1 month after | 1.42/NR | 16.4 | MVA | PS, treatment, n° of metastatic sites, NLR, antibiotic use | 7 |
| Hakozaki/ 2019 |
retrospective | 90 (NSCLC) | NIVO (100) | 68 | 14.4/1 month before start | >1 (84.6%)/ | NR | MVA | driver mutations | 6 |
| Huemer/ 2018 |
retrospective | 30 (NSCLC) | NIVO (83), PEMBRO (17) | NR | 37/1 month before/after start | NR/NR | NR | MVA | sex, antibiotic use, ICI, EGFR/ALK mutations, line of tx, PDL1 status, immune-related adverse events | 5 |
| Huemer/ 2019 |
retrospective | 142 (NSCLC) | NIVO, PEMBRO or ATEZO (100) | 66 | 44/1 months before or after start | NR/NR | 13.3 | UVA | NR | 7 |
| Kaderbhai/ 2017 |
retrospective | 74 (NSCLC) | NIVO (100) | 67.5 | 20.3/3 months before or concurrent | 1/NR | NR | UVA (PFS) | NR | 5 |
| Krief/ 2019 |
prospective cohort | 72 (NSCLC) | NIVO (100) | 68.8 | 42/2 months before or 1 month after start | 1.35/1.7 | 16.6 | MVA | AB use; KRAS mutations, gemmatimonadaceae on blood microbiome at baseline | 7 |
| Pinato/ 2019 |
prospective cohort | 196 (NSCLC n = 118; melanoma n = 38; RCC n = 11; other n = 26) | anti-PD(L)1 (96) | 68 | 29/1 month before or concurrent | NR/NR | NR | MVA | response to ICI, AB 0–30 days before ICI | 6 |
| Sen/ 2018 |
retrospective | 172 (NSCLC n = 21; RCC n = 25; melanoma n = 16; sarcoma n = 16; other n = 94) | anti-CTLA4 (61), anti-PD1 (39) | 60 | 33/during and up to 2 mos before | NR/NR | NR | UVA | NR | 5 |
| Tinsley/ 2019 |
retrospective | 291 (melanoma n = 179, RCC n = 48, NSCLC n = 69) | NR | 66 | 32/2w before up to 6w after start | NR/NR | NR | MVA | AB use, comorbidities, metastatic sites > 3, PS > 0 | 6 |
| Zhao/ 2019 |
retrospective | 109 (NSCLC) | anti-PD1 (52.3), anti-PD1 + CT (30.3), anti-PD1 + antiangiogenic (17.4) | 62 | 18.3/1 mos before or after start | NR/NR | NR | MVA | AB use, PS | 6 |
* only immunotherapy without chemotherapy; °: all patients; AB: antibiotic; mos: months; RCC: renal cell carcinoma; NSCLC: non-small-cell lung cancer; PD1: programmed death 1; PDL1: programmed death-ligand 1; ICI: immune checkpoint inhibitors; CT: chemotherapy; CTLA4: Cytotoxic T-lymphocyte antigen 4; BEVA: bevacizumab; NIVO: nivolumab; PEMBRO: pembrolizumab; IPI: ipilimumab; ATEZO: atezolizumab; MVA: multivariate analysis; UVA: univariate analysis; PFS: progression-free survival; IMDC: international metastatic RCC database consortium; PS ECOG: performance status; tx: therapy; NLR: neutrophil to lymphocyte ratio; NR: not reported; AB: antibiotics; combo: combination of two immune checkpoint inhibitors.