Katayama Yuki, Yamada Tadaaki, Shimamoto Takayuki, Iwasaku Masahiro, Kaneko Yoshiko, Uchino Junji, Takayama Koichi
Department of Pulmonary Medicine, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan.
Transl Lung Cancer Res. 2019 Dec;8(6):847-853. doi: 10.21037/tlcr.2019.10.23.
Cancer immunotherapy is being developed as a promising alternative for advanced non-small cell lung cancer (NSCLC). However, novel biomarkers are required to select patients that will benefit from treatment with immune checkpoint inhibitors (ICIs) for a long period of time. The gut microbiome is expected to be a promising biomarker of ICI response owing to the regulation of the immune status within the host.
In this retrospective study, we included 17 Japanese patients with advanced NSCLC who were treated with ICIs for >3 months in our hospital. Fecal samples obtained from the patients during ICI treatment were analyzed by 16S ribosomal RNA gene sequencing. We examined the correlation between the diversity of the gut microbiome and treatment with ICIs.
Several bacterial species were more abundant in ICI responders than in non-responders. Patients with abundant Lactobacillus and Clostridium tended to have a longer time to treatment failure (TTF) after receiving ICI than those with a lower abundance.
In conclusion, the composition of the gut microbiome is associated with better clinical benefits from ICI treatment in Japanese patients with NSCLC. A further large-scale study is warranted to validate the composition of the gut microbiome as a novel clinical factor influencing the response to ICIs for an extended time in NSCLC.
癌症免疫疗法正被开发为晚期非小细胞肺癌(NSCLC)的一种有前景的替代疗法。然而,需要新的生物标志物来筛选能长期从免疫检查点抑制剂(ICI)治疗中获益的患者。由于宿主内免疫状态的调节,肠道微生物群有望成为ICI反应的一种有前景的生物标志物。
在这项回顾性研究中,我们纳入了17例在我院接受ICI治疗超过3个月的日本晚期NSCLC患者。对ICI治疗期间从患者获取的粪便样本进行16S核糖体RNA基因测序分析。我们研究了肠道微生物群多样性与ICI治疗之间的相关性。
几种细菌种类在ICI反应者中比在无反应者中更为丰富。乳酸杆菌和梭菌丰富的患者在接受ICI治疗后比那些丰度较低的患者往往有更长的至治疗失败时间(TTF)。
总之,在日本NSCLC患者中,肠道微生物群的组成与ICI治疗带来的更好临床获益相关。有必要进行进一步的大规模研究,以验证肠道微生物群的组成作为一种新的临床因素在NSCLC中对ICI反应产生长期影响。