Department of Liver Surgery, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College (CAMS & PUMC), Beijing, China.
Department of General Surgery Center, Beijing Youan Hospital, Clinical Center for Liver Cancer, Capital Medical University, Beijing, China.
J Immunother Cancer. 2024 Jun 6;12(6):e008686. doi: 10.1136/jitc-2023-008686.
BACKGROUND: The association between gut bacteria and the response to immune checkpoint inhibitors (ICI) in hepatocellular carcinoma (HCC) has been studied; however, multi-kingdom gut microbiome alterations and interactions in ICI-treated HCC cohorts are not fully understood. METHODS: From November 2018 to April 2022, patients receiving ICI treatment for advanced HCC were prospectively enrolled. Herein, we investigated the multi-kingdom microbiota characterization of the gut microbiome, mycobiome, and metabolome using metagenomic, ITS2, and metabolomic data sets of 80 patients with ICI-treated HCC. RESULTS: Our findings demonstrated that bacteria and metabolites differed significantly between the durable clinical benefit (DCB) and non-durable clinical benefit (NDB) groups, whereas the differences were smaller for fungi. The overall diversity of bacteria and fungi before treatment was higher in the DCB group than in the NDB group, and the difference in diversity began to change with the use of immunotherapy after 6-8 weeks. We also explored the alterations of gut microbes in the DCB and NDB groups, established 18 bacterial species models as predictive biomarkers for predicting whether immunotherapy is of sustained benefit (area under the curve=75.63%), and screened two species of bacteria (, and ) and one metabolite (galanthaminone) as prognostic biomarkers for predicting survival in patients with HCC treated with ICI. CONCLUSIONS: In this study, the status and characterization of the multi-kingdom microbiota, including gut bacteria, fungi, and their metabolites, were described by multiomics sequencing for the first time in patients with HCC treated with ICI. Our findings demonstrate the potential of bacterial taxa as predictive biomarkers of ICI clinical efficacy, and bacteria and their metabolites as prognostic biomarkers.
背景:已经研究了肠道细菌与肝细胞癌(HCC)对免疫检查点抑制剂(ICI)的反应之间的关联;然而,ICI 治疗的 HCC 队列中多王国肠道微生物组的改变和相互作用尚不完全清楚。
方法:从 2018 年 11 月至 2022 年 4 月,前瞻性纳入接受 ICI 治疗的晚期 HCC 患者。在此,我们使用 80 名接受 ICI 治疗的 HCC 患者的宏基因组、ITS2 和代谢组学数据集,研究了肠道微生物组、菌和代谢组的多王国微生物群落特征。
结果:我们的研究结果表明,细菌和代谢物在具有持久临床获益(DCB)和无持久临床获益(NDB)的组之间有显著差异,而真菌的差异较小。在治疗前,DCB 组的细菌和真菌总体多样性高于 NDB 组,并且这种多样性的差异在 6-8 周后开始随着免疫治疗的使用而改变。我们还探讨了 DCB 和 NDB 组中肠道微生物的变化,建立了 18 种细菌物种模型作为预测免疫治疗是否具有持续获益的预测生物标志物(曲线下面积=75.63%),并筛选出两种细菌(和)和一种代谢物(加兰他敏酮)作为预测接受 ICI 治疗的 HCC 患者生存的预后生物标志物。
结论:在这项研究中,首次通过多组学测序描述了接受 ICI 治疗的 HCC 患者的多王国微生物群,包括肠道细菌、真菌及其代谢物的状态和特征。我们的研究结果表明,细菌分类群作为 ICI 临床疗效的预测生物标志物的潜力,以及细菌及其代谢物作为预后生物标志物的潜力。
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