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Gut Microbiota and Sunitinib-Induced Diarrhea in Metastatic Renal Cell Carcinoma: A Pilot Study
Zhimin Su1,2, Linbin Lu1, Fuyu Chen3
1Department of Oncology, 900th Hospital of PLA, Fuzong Clinical Medical College of Fujian Medical University, Fuzhou, 350024, People's Republic of China.
Introduction:
Sunitinib-induced diarrhea seriously affects the prognosis of patients with metastatic renal cell carcinoma (mRCC) and reduces their quality of life. We aim to explore and find the relationship between sunitinib-induced diarrhea and gut microbiota.
Methods:
Feces were collected from 31 mRCC patients receiving sunitinib treatment. To characterize the feces gut microbiome profiles of patients, the V3-V4 region of 16S rRNA sequencing was carried out in this study.
Results:
Gut microbial diversity was decreased both in the severe diarrhea group and in the sunitinib-post group. The microbial composition with higher abundance of Bacteroides (mucus degrading bacteria) and lower abundance of Faecalibacterium, Oscillospira, Ruminococcaceae, Eubacterium and Coriobacteriaceae (butyrate-producing bacteria) were found in patients with diarrhea. Interestingly, the abundance of Actinobacteria was decreased in patients receiving sunitinib with severe diarrhea.
Conclusion:
This study reported an association between gut microbiota and sunitinib-induced diarrhea. Defects of the butyrate-producing bacteria and the increase in Bacteroides may be the physiological basis of sunitinib-induced diarrhea.
Insights
Sunitinib treatment for metastatic renal cell carcinoma (mRCC) can cause diarrhea. This study links diarrhea to decreased gut microbial diversity and specific bacterial changes, particularly fewer butyrate-producers.
Area of Science:
- Oncology
- Microbiome research
- Gastroenterology
Background:
- Sunitinib-induced diarrhea negatively impacts metastatic renal cell carcinoma (mRCC) patient prognosis and quality of life.
- Understanding the gut microbiota's role in sunitinib-induced diarrhea is crucial for patient management.
Purpose of the Study:
- To investigate the association between gut microbiota composition and sunitinib-induced diarrhea in mRCC patients.
- To identify specific microbial changes linked to the severity of diarrhea.
Main Methods:
- Fecal samples were collected from 31 mRCC patients undergoing sunitinib treatment.
- 16S rRNA gene sequencing (V3-V4 region) was employed to analyze gut microbiome profiles.
Main Results:
- Reduced gut microbial diversity was observed in patients with severe diarrhea and post-sunitinib treatment.
- Diarrhea was associated with increased abundance of mucus-degrading *Bacteroides* and decreased abundance of butyrate-producing bacteria (e.g., *Faecalibacterium*, *Ruminococcaceae*).
- A decrease in *Actinobacteria* was noted in patients experiencing severe diarrhea.
Conclusions:
- An association exists between gut microbiota alterations and sunitinib-induced diarrhea.
- Reduced butyrate-producing bacteria and increased *Bacteroides* may underlie the physiological mechanisms of sunitinib-induced diarrhea.
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