A metagenome association study of gut microbiome revealed biomarkers for chemotherapy efficacy in locally advanced and advanced lung cancer

Abstract

Background Accumulating evidence has confirmed the important role of the gut microbiome in the development and immunotherapy efficacy of lung cancer. However, little is known about the relationship between intestinal flora and chemotherapy. This study investigates the correlation between intestinal flora and chemotherapy efficacy in lung cancer. Methods We analyzed baseline stool samples from patients with locally advanced and advanced lung cancer before chemotherapy treatment, through metagenomics of the gut microbiota. The composition, diversity, function, and metabolic pathway analysis of the microbial communities were compared, using the R statistical programming language, among patients with different clinical outcomes. Results From September 1, 2018 to September 30, 2019, we obtained stool samples from 64 patients with locally advanced and advanced lung cancer treated with chemotherapy at baseline, consisting of 33 patients who responded to treatment (responders) and 31 patients who did not (non-responders). The median progression-free survival was 7 months (range, 1.5–14.5). Streptococcus mutans and Enterococcus casseliflavus were enriched in responders (P < 0.05), while 11 bacteria including Leuconostoc lactis and Eubacterium siraeum were enriched in non-responders (P < 0.05) by variance analysis. Responders to chemotherapy were associated with significantly higher Acidobacteria and Granulicella, while Streptococcus oligofermentans, Megasphaera micronuciformis, and Eubacterium siraeum were more abundant in non-responders by Lefse analysis. Streptococcus mutans and Enterococcus casseliflavus were further identified as bacterial markers for the responders in chemotherapy using unsupervised clustering, and Leuconostoc lactis and Eubacterium siraeum were the biomarkers for non-responders. Functional analysis of metabolic pathways revealed that the L-glutamate degradation VIII pathway was enriched in responders (P = 0.014), and the C4 photosynthetic carbon assimilation cycle, reductive TCA cycle I, and hexitol fermentation to lactate, formate, ethanol, and acetate were enriched in non-responders (P < 0.05). In addition, significant associations of bacterial species with clinical indicators such as age, body mass index, and pathological patterns were observed by spearman correlation analysis. Conclusions The study showed that the specific gut microbiome of patients with lung cancer might possess a potential predictive role for the clinical outcomes of chemotherapy. Further validation is needed.

COVID-19 Pandemic and Clinical Oncology Concerns

“…It is important to identify vulnerable populations who will be impacted most by this pandemic leading to higher mortality rates compared to the general healthy population. Although older pa-tients and patients with co-morbidities fall into this vulnerable group, patients with hematologic and oncologic malignancies on active cytotoxic treatments are at even greater risk as they are both myelosuppressed and immunosuppressed (38). The COVID-19 pandemic presents a challenge of global reach and significance which is unprecedented in the era of modern hematology and oncology (71).…”

Knowledge, Attitude and Perception of a Sample of Breast Cancer Patients Towards Covid-19 Pandemic

“…Patients with cancer may suffer more during this epidemic period as they are immunocompromised. So their bodies are less likely to be able to fight against the COVID-19 if they got infected (7) . The Center for Disease Control and Prevention (CDC) has published the largest case series to date of COVID-19 in mainland China and reported a case fatality rate of 5.6% among patients with cancer (8) .…”