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The impact of antibiotics and glucocorticoids on the results of immunomodulatory antibody treatment in cancer patients

Izabela Łasińska, Wojciech Leppert
DOI: 10.5603/PMPI.2021.0015

open access

Ahead of Print
Review articles
Published online: 2021-07-05

Abstract

Cancer cells avoid elimination through the mechanism of immunosuppression, which consists in modulating antigens and affecting the activation of the complement system. In 2011, authorities registered a monoclonal antibody and the first medication from the group of immunological checkpoints, ipilimumab, which activates T lymphocytes through unblocking the possibility of presenting antigens to cells after binding with cytotoxic T cell antigen (CTLA-4 ). Other targets of the drugs from this group were described: programmed death cell receptor 1 (PD-1), located on T lymphocytes, and programmed death cell ligand 1 (PD-L1), located on cancer cells. Immunotherapy significantly improved the prognosis of patients diagnosed with melanoma, renal cell carcinoma, squamous cell carcinomas of the head and neck, non-small cell lung cancer and other cancers.

Glucocorticoids are often used in the treatment of symptoms in cancer patients. They are also administered during immunotherapy in the case autoimmune complications. Antibiotics also constitute a group of medications that are widely used in cancer patients. Since both glucocorticoids and antibiotics can decrease the effectiveness of immunotherapy, physicians should carefully consider the expected benefits and the possible negative impact of their administration on the survival time of cancer patients before prescribing them.

Abstract

Cancer cells avoid elimination through the mechanism of immunosuppression, which consists in modulating antigens and affecting the activation of the complement system. In 2011, authorities registered a monoclonal antibody and the first medication from the group of immunological checkpoints, ipilimumab, which activates T lymphocytes through unblocking the possibility of presenting antigens to cells after binding with cytotoxic T cell antigen (CTLA-4 ). Other targets of the drugs from this group were described: programmed death cell receptor 1 (PD-1), located on T lymphocytes, and programmed death cell ligand 1 (PD-L1), located on cancer cells. Immunotherapy significantly improved the prognosis of patients diagnosed with melanoma, renal cell carcinoma, squamous cell carcinomas of the head and neck, non-small cell lung cancer and other cancers.

Glucocorticoids are often used in the treatment of symptoms in cancer patients. They are also administered during immunotherapy in the case autoimmune complications. Antibiotics also constitute a group of medications that are widely used in cancer patients. Since both glucocorticoids and antibiotics can decrease the effectiveness of immunotherapy, physicians should carefully consider the expected benefits and the possible negative impact of their administration on the survival time of cancer patients before prescribing them.

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Keywords

cancer immunotherapy, antibiotics, glucocorticoids, side effects

About this article
Title

The impact of antibiotics and glucocorticoids on the results of immunomodulatory antibody treatment in cancer patients

Journal

Palliative Medicine in Practice

Issue

Ahead of Print

Article type

Review paper

Published online

2021-07-05

DOI

10.5603/PMPI.2021.0015

Keywords

cancer immunotherapy
antibiotics
glucocorticoids
side effects

Authors

Izabela Łasińska
Wojciech Leppert

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