接受化学免疫治疗的高级NSCLC的肠道微生物群:来自第三阶段试验JCOG2007 (NIPPON) 的辅助生物标志物研究
Taiki Hakozaki1, Kentaro Tanaka2, Yoshimasa Shiraishi2
1Department of Thoracic Oncology and Respiratory Medicine, Tokyo Metropolitan Cancer and Infectious Diseases Center, Komagome Hospital, Bunkyo, Tokyo, Japan.
概括
肠道微生物群的组成,包括像Fusicatenibacter和Butyricicoccus这样的属,可以预测接受化疗免疫治疗的非小细胞肺癌 (NSCLC) 患者的生存率和严重不良事件. 这些微生物特征可以指导个性化治疗策略.
科学领域:
- 在瘤学瘤学.
- 微生物组研究 微生物组研究
- 免疫治疗是一种免疫疗法.
背景情况:
- 免疫疗法已推进非小细胞肺癌 (NSCLC) 治疗,但可靠的生物标志物用于患者选择是有限的.
- 肠道微生物群作为NSCLC化疗免疫治疗中的生物标志物的潜力在很大程度上仍未被探索.
研究的目的:
- 在接受化疗免疫治疗的晚期NSCLC患者中,研究肠道微生物群组成与临床结果 (整体存活率和不良事件) 之间的关联.
- 探索肠道微生物群对治疗反应的潜在疗法特异性影响.
主要方法:
- 一项III期试验 (JCOG2007,NIPPON) 在未经治疗的先进NSCLC患者中比较了两种化疗免疫疗法方案 (pembrolizumab加化疗与nivolumab/ipilimumab加化疗).
- 用270名患者便样本的16S核糖体DNA测序分析了肠道微生物组组成,与整体存活率和不良事件相关.
主要成果:
- 在总生存时间较长 (≥12或≥18个月) 和较短的患者之间观察到明显的肠道微生物结构.
- 包括Fusicatenibacter,Butyricicoccus和Blautia在内的特定细菌系在患者中具有更长的存活时间,并与较低的严重不良事件风险相关.
- 在尼沃卢马布/伊皮利穆马布加化疗手臂中,富含Fusicatenibacter和Butyricicoccus的较高数量与更好的生存率相关,而在同一手臂中,Prevotellaceae NK3B31的丰富性与较高的死亡风险有关.
结论:
- 肠道微生物群的组成作为一个潜在的预测生物标志物,用于化学免疫疗法的疗效和毒性在先进的NSCLC.
- 微生物多样性和特定类型与预后和严重不良事件有关,具有潜在的方案特异性影响.
- 将肠道微生物群分析整合到临床实践中可以优化NSCLC患者的第一线治疗选择.
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