Impact of the gut microbiome on response and toxicity to chemotherapy in advanced esophageal cancer.

OBJECTIVE

To identify the gut bacteria associated with chemotherapeutic outcomes, t characterized the gut microbiota in patients with esophageal squamous cell carcinoma (ESCC) in this prospective study.

DESIGN

Thirty-one patients with ESCC were enrolled. Chemotherapy was performed with paclitaxel and cisplatin (TP). Fecal samples were collected before and after treatment and analyzed using 16S rRNA sequencing.

RESULTS

The species with differences in baseline abundance between partial response (PR) and non-PR groups was identified as ( = 0.043). The baseline abundance of was higher in the responder (R, PR + stable disease (SD)) group ( = 0.045) than in the non-responder (NR). The abundance of was identified as a predictor for distinguishing patients with PR from those without PR (sensitivity, 83.3 %; specificity, 69.6 %). The abundance of was positively associated with the response to PR + SD (R) in predicting responders in the receiver operating characteristic (ROC) curve analysis (area under the ROC curve = 0.865,  = 0.041). The abundance of and was a predictor of grade (G) 3-4 chemotherapy toxicities. The sensitivity and specificity of the established multi-analyte microbial predictive model demonstrated a better predictive ability than a single parameter ( or ).

CONCLUSION

The abundance of gut microbiota and are associated with the efficacy of TP chemotherapy in patients with ESCC. The abundance of and may related to the toxicity of TP chemotherapy.