EBMT 2025 | The potential impact of antibiotic exposure before CAR-T on therapeutic outcomes
In this video, Florent Malard, MD, PhD, Saint-Antoine Hospital and Sorbonne University, Paris, France, briefly comments on the potential impact of antibiotic exposure before CAR T-cell therapy on patients’ therapeutic outcomes. Dr Malard notes that dysbiosis has been linked to poorer outcomes after CAR-T cell therapy and that antibiotic use contributes to its occurrence. He suggests that modulating the gut microbiota before CAR T-cell therapy may be necessary to improve treatment outcomes in patients with dysbiosis. This interview took place at the 51st Annual Meeting of the EBMT in Florence, Italy.
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Transcript
Over the last few years, we have several papers that have been published that link dysbiosis with patients’ outcomes after CAR T-cell therapy, and it seems to be linked with the use of antibiotics because, of course, antibiotics, when you use them before CAR T-cells, will decrease the gut microbiota diversity and will induce some dysbiosis. We can see some data that suggests that maybe it’s just that because patients with more severe disease receive more antibiotics, so this is just why we have an impact on the patient’s outcome...
Over the last few years, we have several papers that have been published that link dysbiosis with patients’ outcomes after CAR T-cell therapy, and it seems to be linked with the use of antibiotics because, of course, antibiotics, when you use them before CAR T-cells, will decrease the gut microbiota diversity and will induce some dysbiosis. We can see some data that suggests that maybe it’s just that because patients with more severe disease receive more antibiotics, so this is just why we have an impact on the patient’s outcome. But there are also some studies that have been conducted with very well-designed studies that clearly established that it’s not only that, and that we really have a story between the use of antibiotics, the gut dysbiosis, and the response to CAR T-cell therapy. And it seems that we have an effect of the microbiome on the efficacy of the CAR T-cell, precisely that will maybe be less effective in controlling the tumors. So here also again we may need to have some gut microbiota modulation, maybe also some fecal microbiota transfer before CAR T-cell therapy in patients with dysbiosis to improve the efficacy of the CAR T-cell therapy.
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Disclosures
BMS: Honoraria; Therakos/Mallinckrodt: Honoraria; Sanofi: Honoraria; JAZZ Pharmaceuticals: Honoraria; Gilead: Honoraria; Novartis: Honoraria; AstraZeneca: Honoraria; MSD: Honoraria.
