Impact of antibiotics, corticosteroids, and microbiota on immunotherapy efficacy in patients with non-small cell lung cancer.

Autor:	Zapata-García M; Medical Oncology Department, Lozano Blesa University Hospital Clinic, 50009, Zaragoza, Spain.; Health Research Institute of Aragón (IIS Aragón), 50009, Zaragoza, Spain., Moratiel-Pellitero A; Medical Oncology Department, Lozano Blesa University Hospital Clinic, 50009, Zaragoza, Spain., Isla D; Medical Oncology Department, Lozano Blesa University Hospital Clinic, 50009, Zaragoza, Spain.; Health Research Institute of Aragón (IIS Aragón), 50009, Zaragoza, Spain., Gálvez E; Institute of Carbochemistry (ICB-CSIC), Zaragoza, Spain.; Center for Biomedical Research in the Network of Infectious Diseases (CIBERINFEC), Carlos III Health Institute (ISCIII), Madrid, Spain., Gascón-Ruiz M; Health Research Institute of Aragón (IIS Aragón), 50009, Zaragoza, Spain.; Medical Oncology Department, Miguel Servet University Hospital, 50009, Zaragoza, Spain., Sesma A; Health Research Institute of Aragón (IIS Aragón), 50009, Zaragoza, Spain.; Medical Oncology Department, Miguel Servet University Hospital, 50009, Zaragoza, Spain., Barbero R; Microbiology Department, Ramón y Cajal University Hospital and IRYCIS, Madrid, Spain., Galeano J; Complex Systems Group, Universidad Politécnica de Madrid, Madrid, Spain., Del Campo R; Center for Biomedical Research in the Network of Infectious Diseases (CIBERINFEC), Carlos III Health Institute (ISCIII), Madrid, Spain.; Microbiology Department, Ramón y Cajal University Hospital and IRYCIS, Madrid, Spain., Ocáriz M; Medical Oncology Department, Lozano Blesa University Hospital Clinic, 50009, Zaragoza, Spain., Quílez E; Medical Oncology Department, Lozano Blesa University Hospital Clinic, 50009, Zaragoza, Spain.; Health Research Institute of Aragón (IIS Aragón), 50009, Zaragoza, Spain., Cruellas M; Medical Oncology Department, Vall d'Hebrón University Hospital, 08035, Barcelona, Spain., Remírez-Labrada A; Health Research Institute of Aragón (IIS Aragón), 50009, Zaragoza, Spain., Pardo J; Health Research Institute of Aragón (IIS Aragón), 50009, Zaragoza, Spain.; Center for Biomedical Research in the Network of Infectious Diseases (CIBERINFEC), Carlos III Health Institute (ISCIII), Madrid, Spain.; Microbiology Department, Preventive Medicine and Public Health, University of Zaragoza, 50009, Zaragoza, Spain., Martínez-Lostao L; Microbiology Department, Preventive Medicine and Public Health, University of Zaragoza, 50009, Zaragoza, Spain., Domingo MP; Institute of Carbochemistry (ICB-CSIC), Zaragoza, Spain., Esteban P; Health Research Institute of Aragón (IIS Aragón), 50009, Zaragoza, Spain., Torres-Ramón I; Medical Oncology Department, Lozano Blesa University Hospital Clinic, 50009, Zaragoza, Spain.; Health Research Institute of Aragón (IIS Aragón), 50009, Zaragoza, Spain., Yubero A; Medical Oncology Department, Lozano Blesa University Hospital Clinic, 50009, Zaragoza, Spain.; Health Research Institute of Aragón (IIS Aragón), 50009, Zaragoza, Spain., Paño JR; Health Research Institute of Aragón (IIS Aragón), 50009, Zaragoza, Spain.; ESCMID Fellow, Infectious Diseases Department, Lozano Blesa University Hospital Clinic, Zaragoza, Spain and University of Zaragoza, 50009, Zaragoza, Spain., Lastra R; Medical Oncology Department, Lozano Blesa University Hospital Clinic, 50009, Zaragoza, Spain.; Health Research Institute of Aragón (IIS Aragón), 50009, Zaragoza, Spain.
Jazyk:	angličtina
Zdroj:	Heliyon [Heliyon] 2024 Jul 01; Vol. 10 (13), pp. e33684. Date of Electronic Publication: 2024 Jul 01 (Print Publication: 2024).
DOI:	10.1016/j.heliyon.2024.e33684
Abstrakt:	Lung cancer is a leading cause of morbidity and mortality globally, with its high mortality rate attributed mainly to non-small cell lung cancer (NSCLC). Although immunotherapy with immune checkpoint inhibitors (ICI) has revolutionized its treatment, patient response is highly variable and lacking predictive markers. We conducted a prospective study on 55 patients with NSCLC undergoing ICI therapy to identify predictive markers of both response and immune-related adverse events (IrAEs) in the airway microbiota. We also analyzed the clinical evolution and overall survival (OS) with respect to treatments that affect the integrity of the microbiota, such as antibiotics and corticosteroids. Our results demonstrated that respiratory microbiota differ significantly in ICI responders: they have higher alpha diversity values and lower abundance of the Firmicutes phylum and the Streptococcus genus. Employing a logistic regression model, the abundance of Gemella was the major predictor of non-ICI response, whereas Lachnoanaerobaculum was the best predictor of a positive response to ICI. The most relevant results were that antibiotic consumption is linked to a lower ICI response, and the use of corticosteroids correlated with poorer overall survival. Whereas previous studies have focused on gut microbiota, our findings highlight the importance of the respiratory microbiota in predicting the treatment response. Future research should explore microbiota modulation strategies to enhance immunotherapy outcomes. Understanding the impact of antibiotics, corticosteroids, and microbiota on NSCLC immunotherapy will help personalize treatment and improve patient outcomes. Competing Interests: The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper. (© 2024 The Authors.)
Databáze:	MEDLINE
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