H pylori infection may diminish immunotherapy response in Acute gastric cancer patients

Written By : Dr. Shravani Dali |Medically Reviewed By : Dr. Kamal Kant Kohli Published On 2022-05-30T09:45:59+05:30 | Updated On 30 May 2022 2:56 PM IST

Patients with advanced gastric cancer and active Helicobacter pylori (H pylori) infection may have a diminished response to anti-programmed cell death-1 (anti-PD-1) antibody therapy and shorter progression-free survival (PFS) and overall survival (OS), suggests a recent study published in the Research Square.

Accumulating evidence has revealed that the gut microbiota influences the effectiveness of immune checkpoint inhibitors (ICIs) in cancer patients. As a part of the human microbiome, Helicobacter pylori (H. pylori) was reported to be associated with reduced effectiveness of anti-PD1 immunotherapy in patients with non-small-cell lung cancer (NSCLC). Gastric cancer is more closely related to H. pylori, so we conducted a retrospective analysis to verify whether the association of H. pylori and effectiveness is applicable to advanced gastric cancer (AGC) patients. Advanced gastric cancer patients who had evidence of H. pylori and received anti-PD-1 antibodies were enrolled in the study. The differences in the disease control rate (DCR), overall survival (OS) and progression-free survival (PFS) between the H. pylori-positive group and the negative group were compared.

Results:

A total of 77 patients were included in this study; 34 patients were H. pylori-positive, and the prevalence of H. pylori infection was 44.2%. Compared with the H. pylori-negative group, patients in the H. pylori-positive group had a higher risk of nonclinical response to anti-PD-1 antibody, with an OR of 2.91 (95% CI: 1.13-7.50). Patients in the H. pylori-negative group had a longer OS and PFS than those in the positive group, with an estimated median OS of 17.5 months vs. 6.2 months (HR = 2.85, 95% CI: 1.70-4.78; P = 0.021) and a median PFS of 8.4 months vs. 2.7 months (HR=3.11, 95% CI: 1.96-5.07, P=0.008). Multivariate analysis indicated that H. pylori infection was independently associated with PFS (HR=1.90, 95% CI: 1.10-3.30; P=0.022).

Thus, the study unveils for the first time that H. pylori infection is associated with the outcome of immunotherapy for advanced gastric cancer patients. A multicenter, large sample and prospective clinical studies are needed to verify the association.

Reference:

Association of Helicobacter pylori infection with survival outcomes in advanced gastric cancer patients treated with immune checkpoint inhibitors by Hebin Che, et al. published in the Research Square

https://doi.org/10.21203/rs.3.rs-1590446/v1

Advanced gastric cancerImmune checkpointinhibitorsHelicobacter pyloriPrognosis

Source : Research Square

Dr. Shravani Dali

Dr. Shravani Dali has completed her BDS from Pravara institute of medical sciences, loni. Following which she extensively worked in the healthcare sector for 2+ years. She has been actively involved in writing blogs in field of health and wellness. Currently she is pursuing her Masters of public health-health administration from Tata institute of social sciences. She can be contacted at editorial@medicaldialogues.in.

Dr. Kamal Kant Kohli

Dr Kamal Kant Kohli-MBBS, DTCD- a chest specialist with more than 30 years of practice and a flair for writing clinical articles, Dr Kamal Kant Kohli joined Medical Dialogues as a Chief Editor of Medical News. Besides writing articles, as an editor, he proofreads and verifies all the medical content published on Medical Dialogues including those coming from journals, studies,medical conferences,guidelines etc. Email: drkohli@medicaldialogues.in. Contact no. 011-43720751