By Neena Bhandari

Sydney, 28.08.2025 (Oncology Republic): The complex interplay between antibiotics, gut microbiota and immune-modulating drugs in cancer treatment have been the focus of several studies for nearly a decade. It appears that antibiotics can disrupt gut microbiota diversity, which influences how well patients respond to immune checkpoint inhibitors and other immunotherapies, say researchers.

Dr Miles Andrews, consultant medical oncologist and head of Immuno-oncology at The Alfred, and research fellow at Monash University explains. “There have been some studies on the exposure to antibiotics in the 30 to 90 days prior to starting immune checkpoint inhibitor therapy for cancer,” he told Oncology Republic. “And there’s certainly a suggestion that antibiotic exposure is associated with an inferior overall survival across a range of epithelial cancers, for example, kidney and lung cancer, as well as melanoma.”

Several translational research models and pre-clinical models, mainly mice models of cancer, suggest that antibiotic exposure, presumably by altering the gut microbiome, has this negative effect on response to immune checkpoint blockade in cancer.

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By Neena Bhandari

Sydney, 28.08.2025 (Oncology Republic): Overall survival benefit is compelling enough to consider talazoparib and enzalutamide combination as standard first line therapy in patients with metastatic castration-resistant prostate cancer and mutations in the homologous recombination repair genes, particularly those with BRCA1 and BRCA2 gene mutations, researchers say.

Their findings from the final analysis from the TALAPRO-2 trial have been recently published in The Lancet. Talazoparib plus enzalutamide combination significantly improved OS compared with enzalutamide plus placebo (HR 0·62 [95% CI 0·48–0·81, p=0.0005) in patients with HRR-deficient mCRPC. The median OS was 45.1 months with the combination versus 31.1 months with enzalutamide alone.

Professor Arun Azad, co-author of the study, and medical oncologist at Peter MacCallum Cancer Centre said the findings were important. “The data from this trial shows that there’s a statistically significant and also clinically meaningful improvement in survival and quality of life for patients using this combination, as opposed to enzalutamide alone, which is the standard of care,” he said.

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