Juan Zhang, Qing Zhang, Yongping Liang, Qian Liyuan, Wu Wei, Wen Yanguang, Tong Jianbin, Ding Boni
Department of Breast Surgery, Tangshan People's Hospital, Tangshan, Hebei, China.
Department of Breast and Thyroid Surgery, Third Xiangya Hospital, Central South University, Changsha, China.
Front Nutr. 2021 Dec 2;8:762929. doi: 10.3389/fnut.2021.762929. eCollection 2021.
Docetaxel is an important chemotherapy-agent for breast cancer treatment. One of its side-effects is weight gain, which increases the all-cause mortality rate. Considering gut microbiota is one important factor for weight regulation, we hypothesized that probiotics could be potentially used to reduce the docetaxel-related weight gain in breast cancer patients. From 10/8/2018 to 10/17/2019, 100 breast cancer (Stage I-III) patients underwent four cycles of docetaxel-based chemotherapy were enrolled and randomly assigned to receive probiotics (, and ) or placebo (supplementary material of the probiotics capsule) treatment for 84 days with three capsules per time, twice/day. The primary outcome: the changes in body weight and body-fat percentage of the patients were measured by a designated physician using a fat analyzer, and the secondary outcomes: the fasting insulin, plasma glucose, and lipids were directly obtained from the Hospital Information System (HIS); The metabolites were measured using liquid chromatography coupled with tandem mass spectrometry (LC-MS/MS); The fecal microbiome was analyzed using bacterial 16S ribosomal RNA (rRNA) gene sequence. All indicators were measured 1 day before the first cycle of docetaxel-based chemotherapy and 21 days after the last cycle of docetaxel-based chemotherapy. Compared with the placebo group, the probiotic group showed significantly smaller changes in body weight (Mean [SD] 0.77 [2.58] vs. 2.70 [3.08], = 0.03), body-fat percentage (Mean [SD] 0.04 [1.14] vs. 3.86 [11.09], = 0.02), and low density lipoprotein (LDL) (Mean [SD]-0.05[0.68] vs. 0.39 [0.58], = 0.002). Moreover, five of the 340 detected plasma metabolites showed significant differences between the two groups. The change of biliverdin dihydrochloride ( = -0.724, = 0.02) was inverse correlated with weight gain. One strain of the phylum and three strains of the genus were detected to be significantly different between the two groups. Also, the changes of ( = -0.917, < 0.001) and ( = -0.894, < 0.001) were inverse correlated with the change of LDL. Probiotics supplement during docetaxel-based chemotherapy for breast cancer treatment may help to reduce the increase in body weight, body-fat percentage, plasma LDL, and minimize the metabolic changes and gut dysbacteriosis. http://www.chictr.org.cn/showproj.aspx?proj=24294, ChiCTR-INQ-17014181.
多西他赛是一种用于乳腺癌治疗的重要化疗药物。其副作用之一是体重增加，这会提高全因死亡率。鉴于肠道微生物群是体重调节的一个重要因素，我们推测益生菌可能有潜力用于减轻乳腺癌患者与多西他赛相关的体重增加。从2018年8月10日至2019年10月17日，100例（I - III期）接受四个周期多西他赛化疗的乳腺癌患者被纳入研究，并随机分配接受益生菌（，和）或安慰剂（益生菌胶囊补充材料）治疗84天，每次三粒胶囊，每天两次。主要结局：由指定医生使用脂肪分析仪测量患者的体重和体脂百分比变化，次要结局：空腹胰岛素、血浆葡萄糖和血脂直接从医院信息系统（HIS）获取；使用液相色谱 - 串联质谱法（LC - MS/MS）测量代谢物；使用细菌16S核糖体RNA（rRNA）基因序列分析粪便微生物群。所有指标在基于多西他赛的化疗第一个周期前1天和基于多西他赛的化疗最后一个周期后21天进行测量。与安慰剂组相比，益生菌组在体重（均值[标准差]0.77[2.58]对2.70[3.08]， = 0.03）、体脂百分比（均值[标准差]0.04[1.14]对3.86[11.09]， = 0.02）和低密度脂蛋白（LDL）（均值[标准差] - 0.05[0.68]对0.39[0.58]， = 0.002）方面的变化显著较小。此外，在检测到的340种血浆代谢物中，有5种在两组之间存在显著差异。盐酸胆红素的变化（ = - 0.724， = 0.02）与体重增加呈负相关。在两组之间检测到一个门的一个菌株和一个属的三个菌株存在显著差异。而且，（ = - 0.917， < 0.001）和（ = - 0.894， < 0.001）的变化与LDL的变化呈负相关。在基于多西他赛的乳腺癌化疗期间补充益生菌可能有助于减轻体重、体脂百分比和血浆LDL的增加，并使代谢变化和肠道菌群失调最小化。http://www.chictr.org.cn/showproj.aspx?proj=24294，ChiCTR - INQ - 17014181 。
