Ocáriz-Díez Maitane, Cruellas Mara, Gascón Marta, Lastra Rodrigo, Martínez-Lostao Luis, Ramírez-Labrada Ariel, Paño José Ramón, Sesma Andrea, Torres Irene, Yubero Alfonso, Pardo Julián, Isla Dolores, Gálvez Eva M
Medical Oncology Department, Lozano Blesa University Clinical Hospital, Zaragoza, Spain.
Instituto de Investigación Sanitaria Aragón (IIS Aragón), Zaragoza, Spain.
Front Oncol. 2020 Sep 24;10:568939. doi: 10.3389/fonc.2020.568939. eCollection 2020.
The advances in molecular biology and the emergence of Next Generation Sequencing (NGS) have revealed that microbiome composition is closely related with health and disease, including cancer. This relationship affects different levels of cancer such as development, progression, and response to treatment including immunotherapy. The efficacy of immune checkpoint inhibitors (ICIs) may be influenced by the concomitant use of antibiotics before, during or shortly after treatment with ICIs. Nevertheless, the linking mechanism between microbiote, host immunity and cancer is not clear and the role of microbiota manipulation and analyses in cancer management has not been clinically validated yet. Regarding the use of microbiome as biomarker to predict ICI efficacy it has been recently shown that the use of biochemical serum markers to monitor intestinal permeability and loss of barrier integrity, like citrulline, could be useful to monitor microbiota changes and predict ICI efficacy. There are still many unknowns about the role of these components, their relationship with the microbiota, with the use of antibiotics and the response to immunotherapy. The next challenge in microbiome research will be to identify individual microbial species that causally affect lung cancer phenotypes and response to ICI and disentangle the underlying mechanisms. Thus, further analyses in patients with lung cancer receiving treatment with ICIs and its correlation with the composition of the microbiota in different organs including the respiratory tract, peripheral blood and intestinal tract could be useful to predict the efficacy of ICIs and its modulation with antibiotic use.
分子生物学的进展以及新一代测序（NGS）的出现表明，微生物组组成与包括癌症在内的健康和疾病密切相关。这种关系影响癌症的不同层面，如发展、进展以及对包括免疫疗法在内的治疗的反应。免疫检查点抑制剂（ICI）的疗效可能会受到在ICI治疗之前、期间或之后不久同时使用抗生素的影响。然而，微生物群、宿主免疫和癌症之间的联系机制尚不清楚，微生物群操纵和分析在癌症管理中的作用尚未得到临床验证。关于将微生物组用作预测ICI疗效的生物标志物，最近有研究表明，使用生化血清标志物（如瓜氨酸）来监测肠道通透性和屏障完整性丧失，可能有助于监测微生物群变化并预测ICI疗效。关于这些成分的作用、它们与微生物群的关系、抗生素的使用以及对免疫疗法的反应，仍有许多未知之处。微生物组研究的下一个挑战将是识别因果影响肺癌表型和对ICI反应的单个微生物物种，并理清潜在机制。因此，对接受ICI治疗的肺癌患者进行进一步分析，以及分析其与包括呼吸道、外周血和肠道在内的不同器官中微生物群组成的相关性，可能有助于预测ICI疗效及其与抗生素使用的调节关系。
