Antibiotic therapy and outcomes with gemcitabine, cisplatin and durvalumab in advanced cholangiocarcinoma: A large real-world analysis.

815 Background: Antibiotic exposure within close proximity to the initiation of systemic chemoimmunotherapy often occurs in patients diagnosed with cholangiocarcinoma (CCA). However, the data regarding the clinical impact of antibiotic exposure on outcomes are conflicting and limited. We sought to evaluate the impact of antibiotic therapy with chemoimmunotherapy in a large real-world cohort of patients with CCA. Methods: We conducted a retrospective analysis using the TriNetX database using ICD-10 codes to identify patients diagnosed with advanced CCA who received therapy with Gemcitabine, Cisplatin and Durvalumab. These patients were further stratified into two cohorts: those who received oral or intravenous antibiotic therapy in 15 days leading up to or 15 days after initiation of chemoimmunotherapy versus those who did not. Baseline characteristics were compared between the two cohorts. Survival outcomes were assessed using Kaplan-Meier survival analysis. A p-value of