Antibiotics use before/during the ICI (PD-1/PD-L1) treatments

[Olga]

A study from Gustave Roussy Cancer Campus
Gut microbiome influences efficacy of PD-1–based immunotherapy against epithelial tumors
http://science.sciencemag.org/content/359/6371/91
showed that people who received antibiotics to treat infections shortly before or after starting immunotherapy did not respond as well to PD-1-blocking therapies.
Antibiotics indeed kill the pathogenic bacteria but also kill the normal ones, that are needed for the gut function. The best strategy is to avoid antibiotics if possible or to delay the start of the ICI drugs till the gut function somehow recovers - take probiotics, some bacteria will colonize the gut again. Unfortunately only limited variety of the bacteria can be taken in the probiotic supplements, as many of them die in a contact with oxygen. Fecal transplant or diet modification can help the needed bacteria to recover but it takes time.