Antimicrobial Exposure is Associated with Decreased Survival in Triple-negative Breast Cancer

Overview

Journal Nat Commun

Specialty Biology

Date 2023 Apr 12

PMID 37045824

Authors

Julia D Ransohoff

Victor Ritter

Natasha Purington

Karen Andrade

Summer Han

Mina Liu

Su-Ying Liang

Esther M John

Scarlett L Gomez

Melinda L Telli

Lidia Schapira

Haruka Itakura

George W Sledge

Ami S Bhatt

Allison W Kurian

Affiliations

Soon will be listed here.

Abstract

Antimicrobial exposure during curative-intent treatment of triple-negative breast cancer (TNBC) may lead to gut microbiome dysbiosis, decreased circulating and tumor-infiltrating lymphocytes, and inferior outcomes. Here, we investigate the association of antimicrobial exposure and peripheral lymphocyte count during TNBC treatment with survival, using integrated electronic medical record and California Cancer Registry data in the Oncoshare database. Of 772 women with stage I-III TNBC treated with and without standard cytotoxic chemotherapy - prior to the immune checkpoint inhibitor era - most (654, 85%) used antimicrobials. Applying multivariate analyses, we show that each additional total or unique monthly antimicrobial prescription is associated with inferior overall and breast cancer-specific survival. This antimicrobial-mortality association is independent of changes in neutrophil count, is unrelated to disease severity, and is sustained through year three following diagnosis, suggesting antimicrobial exposure negatively impacts TNBC survival. These results may inform mechanistic studies and antimicrobial prescribing decisions in TNBC and other hormone receptor-independent cancers.

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