Microbiome as prognostic indicator in oral cancer

Area of Science:

• Oncology
• Microbiology
• Genomics

Background:

• Oral squamous cell carcinoma (OSCC) has a poor prognosis, with existing staging systems inadequately predicting patient outcomes.
• The oral microbiome, a complex ecosystem of microorganisms, is increasingly recognized for its role in cancer development and progression.
• Understanding the oral microbiome's influence on OSCC prognosis is crucial for improving patient management.

Purpose of the Study:

• To investigate the prognostic value of the oral microbiome in oral squamous cell carcinoma (OSCC).
• To compare the predictive accuracy of oral microbiome signatures against traditional prognostic indicators.
• To explore the functional pathways and immune interactions associated with oral microbiome patterns in OSCC.

Main Methods:

• Analysis of oral microbiome composition through non-invasive sampling and sequencing.
• Development and validation of microbiome-based prognostic models.
• Correlation of microbial signatures and functional pathways with clinical outcomes (recurrence, survival).
• Assessment of the impact of oral microbiome dysbiosis on treatment response and mucositis.

Main Results:

• Specific oral microbial signatures, including pathogens (e.g., Fusobacterium nucleatum) and commensals (e.g., Veillonella), were strongly associated with OSCC recurrence and survival.
• Microbiome-based models demonstrated superior performance in stratifying recurrence risk compared to traditional TNM staging.
• Distinct beta diversity patterns differentiated recurrent from non-recurrent OSCC cases.
• Prognostic relevance was observed in functional pathways like PI3K/AKT/mTOR signaling and immunomodulation, with high-risk patterns linked to immune evasion.

Conclusions:

• The oral microbiome serves as a powerful, non-invasive prognostic indicator for oral squamous cell carcinoma (OSCC).
• Microbiome profiling can refine risk stratification and personalize treatment strategies for OSCC patients.
• Interventions targeting the oral microbiome, such as probiotics, show potential for improving therapeutic outcomes and managing side effects like mucositis.