目的 探討抗生素（ATB）及質(zhì)子泵抑制劑（PPI）對(duì)免疫檢查點(diǎn)抑制劑（ICI）治療療效的影響。方法 選取2020年12月至2022年11月于甘肅省腫瘤醫(yī)院進(jìn)行ICI治療的晚期實(shí)體腫瘤患者為研究對(duì)象，通過電子病歷收集相關(guān)臨床信息，采用Kaplan-Meier生存曲線分析抗生素、PPI使用對(duì)患者總生存期（OS）及無進(jìn)展生存期（PFS）的影響，通過Cox單因素和多因素比例風(fēng)險(xiǎn)模型分析患者預(yù)后的影響因素。結(jié)果 未使用抗生素（Non-ATB）組患者的中位PFS及中位OS明顯優(yōu)于使用抗生素（ATB）組，ATB的使用與接受ICI治療的晚期實(shí)體惡性腫瘤患者的PFS及OS顯著相關(guān)，ATB的使用是影響接受ICI治療的晚期實(shí)體惡性腫瘤患者PFS及OS的獨(dú)立預(yù)后因素。未使用PPI（Non-PPI）組患者的中位PFS及中位OS明顯優(yōu)于使用PPI（PPI）組，PPI的使用與接受ICI治療的晚期實(shí)體惡性腫瘤患者PFS及OS顯著相關(guān)，PPI的使用是影響接受ICI治療的晚期實(shí)體惡性腫瘤患者OS的獨(dú)立預(yù)后因素。未合并使用ATB或（和） PPI患者的中位PFS及中位OS明顯優(yōu)于合并使用ATB或（和） PPI組，合并使用ATB或（和） PPI與接受ICI治療的晚期實(shí)體惡性腫瘤患者的PFS及OS顯著相關(guān)，合并使用ATB或（和） PPI是影響接受ICI治療的晚期實(shí)體惡性腫瘤患者PFS及OS的獨(dú)立預(yù)后因素。結(jié)論 在晚期實(shí)體腫瘤患者中，ATB及PPI的使用可能會(huì)降低ICI治療的療效。

Objective To investigate the effect of antibiotics (ATB) and proton pump inhibitors (PPI) on the efficacy of immune checkpoint inhibitor therapy. Methods Patients with advanced solid tumors who underwent immune checkpoint inhibitor therapy in Gansu Provincial Cancer Hospital from December 2020 to November 2022 were selected as the study subjects, and relevant clinical information was collected through electronic medical records. The Kaplan-Meier survival curve was used to analyze the impact of ATB and PPI use on overall survival (OS) and progression-free survival (PFS). The Cox univariate and multivariate proportional hazards models were used to analyze the influencing factors of patient prognosis. Results The median PFS and median OS of patients in the non-ATB group were significantly better than those in the ATB group, and the use of ATB was significantly correlated with PFS and OS in patients with advanced solid malignancies treated with ICI, and the use of ATB was an independent prognostic factor affecting PFS and OS in patients with advanced solid malignancies treated with ICI. The median PFS and median OS of patients in the non-PPI group were significantly better than those in the PPI group, and the use of PPI was significantly correlated with PFS and OS in patients with advanced solid malignancies treated with ICI, and the use of PPI was an independent prognostic factor affecting the OS of patients with advanced solid malignancies treated with ICI. The median PFS and median OS of patients without concomitant ATB and/or PPI were significantly better than those in the concomitant ATB and/or PPI group, and the concomitant ATB or/or PPI was significantly associated with PFS and OS in patients with advanced solid malignancies treated with ICI, and the concomitant use of ATB and/or PPI was an independent prognostic factor affecting PFS and OS in patients with advanced solid malignancies treated with ICI. Conclusion The use of antibiotics and proton pump inhibitors may reduce the efficacy of ICI in patients with advanced solid tumors.

R969

蘭州市科學(xué)技術(shù)局蘭州市科技發(fā)展指導(dǎo)性計(jì)劃項(xiàng)目（2022-5-108）； 甘肅省藥品監(jiān)督管理局藥品監(jiān)管科學(xué)研究項(xiàng)目（2025GSMPA078）