{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,16]],"date-time":"2026-07-16T06:04:41Z","timestamp":1784181881018,"version":"3.55.0"},"reference-count":35,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,7,15]],"date-time":"2026-07-15T00:00:00Z","timestamp":1784073600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,7,15]],"date-time":"2026-07-15T00:00:00Z","timestamp":1784073600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Head &amp; Neck"],"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>The clinical relevance of antibiotic exposure on immune checkpoint inhibitor (ICI) efficacy in head and neck squamous cell carcinoma (HNSCC) is not well characterized.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This retrospective study included patients with recurrent\/metastatic HNSCC treated between 2015 and 2025. Cox proportional hazards and Kaplan\u2013Meier method modeled overall survival (OS).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Of 316 patients (median age 68\u2009years, 70.9% male), primary tumor site was 40.5% oral cavity, 34.8% oropharynx, 14.9% sinonasal\/nasopharynx, 9.8% hypopharynx\/larynx. One hundred and forty\u2010eight (46.8%) patients received antibiotics surrounding ICI. Antibiotics were associated with decreased OS (HR\u2009=\u20091.53, 95% CI 1.15\u20132.04). On multivariable analysis, while intravenous route of administration and spectrum of antibiotic activity were not risk factors, oral cavity site (HR\u2009=\u20091.72, 95% CI 1.07\u20132.76), ECOG 2\u20134 (HR\u2009=\u20092.78, 95% CI 1.70\u20133.67), PD\u2010L1 CPS\u2009&lt;\u20091 (HR\u2009=\u20093.16, 95% CI 1.79\u20135.04), and number of antibiotic classes (HR\u2009=\u20091.37, 95% CI 1.18\u20131.59) independently predicted decreased OS.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Antibiotic exposure was associated with decreased survival in HNSCC treated with ICI; however, future studies are needed to evaluate potential mechanistic etiologies underlying this association.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/hed.70392","type":"journal-article","created":{"date-parts":[[2026,7,16]],"date-time":"2026-07-16T05:13:01Z","timestamp":1784178781000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Antibiotic Use and Immune Checkpoint Inhibition in Head and Neck Squamous Cell Carcinoma"],"prefix":"10.1002","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0809-9143","authenticated-orcid":false,"given":"Shannon S.","family":"Wu","sequence":"first","affiliation":[{"name":"Division of Head and Neck Surgery, Department of Otolaryngology\u2014Head and Neck Surgery Stanford University School of Medicine  Palo Alto California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vasu","family":"Divi","sequence":"additional","affiliation":[{"name":"Division of Head and Neck Surgery, Department of Otolaryngology\u2014Head and Neck Surgery Stanford University School of Medicine  Palo Alto California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John B.","family":"Sunwoo","sequence":"additional","affiliation":[{"name":"Division of Head and Neck Surgery, Department of Otolaryngology\u2014Head and Neck Surgery Stanford University School of Medicine  Palo Alto California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anushka","family":"Jetly","sequence":"additional","affiliation":[{"name":"Stanford University School of Medicine  Palo Alto California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5917-6209","authenticated-orcid":false,"given":"Fangdi","family":"Sun","sequence":"additional","affiliation":[{"name":"Division of Oncology, Department of Medicine Stanford University  Palo Alto California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A. Dimitrios","family":"Colevas","sequence":"additional","affiliation":[{"name":"Division of Oncology, Department of Medicine Stanford University  Palo Alto California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9594-1414","authenticated-orcid":false,"given":"F. Chris","family":"Holsinger","sequence":"additional","affiliation":[{"name":"Division of Head and Neck Surgery, Department of Otolaryngology\u2014Head and Neck Surgery Stanford University School of Medicine  Palo Alto California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jake","family":"Lee","sequence":"additional","affiliation":[{"name":"Division of Head and Neck Surgery, Department of Otolaryngology\u2014Head and Neck Surgery Stanford University School of Medicine  Palo Alto California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2639-2132","authenticated-orcid":false,"given":"Andrey","family":"Finegersh","sequence":"additional","affiliation":[{"name":"Division of Head and Neck Surgery, Department of Otolaryngology\u2014Head and Neck Surgery Stanford University School of Medicine  Palo Alto California 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