Tortelli Brett A, Contreras Jessika, Markovina Stephanie, Ding Li, Wylie Kristine M, Schwarz Julie K
Department of Radiation Oncology, Washington University School of Medicine, St. Louis, Missouri, USA.
Transitional Year Program, Mercy Hospital St. Louis, St. Louis, Missouri, USA.
JCI Insight. 2025 Feb 4;10(6):e176839. doi: 10.1172/jci.insight.176839.
The standard-of-care treatment of locally advanced cervical cancer includes pelvic radiation therapy with concurrent cisplatin-based chemotherapy and is associated with a 30%-50% failure rate. New prognostic and therapeutic targets are needed to improve clinical outcomes. The vaginal microbiome has been linked to the pathogenesis of cervical cancer, but little is known about the vaginal microbiome in locally advanced cervical cancer as it relates to chemoradiation. In this pilot study, we utilized 16S rRNA gene community profiling to characterize the vaginal microbiomes of 26 postmenopausal women with locally advanced cervical cancer receiving chemoradiation. Our analysis revealed diverse anaerobe-dominated communities whose taxonomic composition, diversity, or bacterial abundance did not change with treatment. We hypothesized that characteristics of the microbiome might correlate with treatment response. Pretreatment microbial diversity and bacterial abundance were not associated with disease recurrence. We observed a greater relative abundance of Fusobacterium in patients who later had cancer recurrence, suggesting that Fusobacterium could play a role in modifying treatment response. Taken together, this hypothesis-generating pilot study provides insight into the composition and dynamics of the vaginal microbiome, offering proof of concept for the future study of the microbiome and its relationship with treatment outcomes in locally advanced cervical cancer.
局部晚期宫颈癌的标准治疗方案包括盆腔放疗联合基于顺铂的同步化疗，其失败率为30%-50%。需要新的预后和治疗靶点来改善临床结局。阴道微生物群与宫颈癌的发病机制有关，但对于局部晚期宫颈癌中与放化疗相关的阴道微生物群知之甚少。在这项初步研究中，我们利用16S rRNA基因群落分析来表征26名接受放化疗的绝经后局部晚期宫颈癌妇女的阴道微生物群。我们的分析揭示了以厌氧菌为主的多样化群落，其分类组成、多样性或细菌丰度不会随治疗而改变。我们假设微生物群的特征可能与治疗反应相关。治疗前的微生物多样性和细菌丰度与疾病复发无关。我们观察到，后来出现癌症复发的患者中梭杆菌的相对丰度更高，这表明梭杆菌可能在改变治疗反应中发挥作用。总之，这项产生假设的初步研究为阴道微生物群的组成和动态提供了见解，为未来研究微生物群及其与局部晚期宫颈癌治疗结局的关系提供了概念验证。
