Cong Jing, Zhang Chuantao, Zhou Siyu, Zhu Jingjuan, Liang Chengwei
College of Marine Science and Biological Engineering, Qingdao University of Science &Technology, Qingdao 266042, China.
Department of Oncology, The Affiliated Hospital of Qingdao University, Qingdao University, Qingdao 266100, China.
Cancers (Basel). 2022 Jul 23;14(15):3599. doi: 10.3390/cancers14153599.
Probiotics as medications have previously been shown to change intestinal microbial characteristics, potentially influencing cancer therapy efficacy. Patients with non-squamous non-small cell lung cancer (NS-NSCLC) treated by bevacizumab plus platinum-based chemotherapy were randomized to obtain Clostridium butyricum supplement (CBS) or receive a placebo as adjuvant therapy. Clinical efficacy and safety were assessed using progression-free survival (PFS), overall survival (OS), and adverse events (AE). Intestinal microbiota was longitudinally explored between CBS and placebo groups over time. Patients who took CBS had significantly decreased bacterial richness and abundance, as well as increased the total richness of the genus Clostridium, Bifidobacterium, and Lactobacillus compared to the placebo group (p < 0.05). Beta diversity and the interactional network of intestinal microbiota were distinctly different between CBS and placebo group. However, there were no significant variations between them in terms of microbial taxonomical taxa and alpha diversity. The potential opportunistic pathogen Shewanella was still detectable after treatment in the placebo group, while no distinguishing microbial markers were found in the CBS group. In terms of clinical efficacy, the CBS group had a significantly reduced AE compare to the placebo group (p < 0.05), although no significantly longer PFS and OS. Therefore, favorable modifications in intestinal microbiota and significant improvements in drug safety make probiotics be promising adjunctive therapeutic avenues for lung cancer treatment.
益生菌作为药物，此前已被证明可改变肠道微生物特征，可能影响癌症治疗效果。接受贝伐单抗联合铂类化疗的非鳞状非小细胞肺癌（NS-NSCLC）患者被随机分组，以获取丁酸梭菌补充剂（CBS）或接受安慰剂作为辅助治疗。使用无进展生存期（PFS）、总生存期（OS）和不良事件（AE）评估临床疗效和安全性。随着时间的推移，纵向探究CBS组和安慰剂组之间的肠道微生物群。与安慰剂组相比，服用CBS的患者细菌丰富度和丰度显著降低，梭菌属、双歧杆菌属和乳酸杆菌属的总丰富度增加（p<0.05）。CBS组和安慰剂组之间的β多样性和肠道微生物群的相互作用网络明显不同。然而，在微生物分类群和α多样性方面，它们之间没有显著差异。安慰剂组治疗后仍可检测到潜在的机会致病菌希瓦氏菌，而CBS组未发现明显的微生物标志物。在临床疗效方面，CBS组的AE比安慰剂组显著减少（p<0.05），尽管PFS和OS没有显著延长。因此，肠道微生物群的有利改变和药物安全性的显著改善使益生菌成为肺癌治疗有前景的辅助治疗途径。
