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Antibiotics impair immunotherapy for urothelial cancer

Pooled clinical trial data reveal that antibiotics worsen progression-free survival and overall survival in patients with locally advanced and metastatic urothelial cancer receiving anti-PDL1 therapy. Consensus guidelines for antibiotic use in these patients, as well as diagnostic tools and corrective measures, are needed to decrease primary resistance to immune checkpoint inhibitors.

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Fig. 1: Antibiotic use in patients receiving immune checkpoint inhibitors.


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L.Z. is supported by the Ligue contre le Cancer (équipe labellisée); Agence Nationale de la Recherche (ANR) – Projets blancs; Association pour la recherche sur le cancer (ARC) SIGN’IN; Cancéropôle Ile-de-France; Fondation pour la Recherche Médicale (FRM); a donation by Elior; Gustave Roussy Odyssea, the European Union Horizon 2020 Project Oncobiome; Fondation Carrefour; Institut National du Cancer (INCa); INSERM; Institut Universitaire de France; LabEx Immuno-Oncology (grant ANR-18-IDEX-0001); Recherche Hospitalo-Universitaire (RHU) Torino Lumière; the Seerave Foundation; and Site de Recherche Intégrée sur le Cancer (SIRIC) Stratified Oncology Cell DNA Repair and Tumor Immune Elimination (SOCRATE).

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L.D. researched data for the article, contributed substantially to discussions of the content and wrote the initial draft. L.D. and L.Z. reviewed and/or edited the manuscript before submission.

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Correspondence to Laurence Zitvogel.

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Competing interests

L.Z. declares that she is a founder of everImmune and conducts research projects for Kaleido, Innovate Pharma and Transgene. L.D. declares no competing interests.

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Derosa, L., Zitvogel, L. Antibiotics impair immunotherapy for urothelial cancer. Nat Rev Urol 17, 605–606 (2020).

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