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2017 ; 19
(10
): 848-855
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Metagenomic Shotgun Sequencing and Unbiased Metabolomic Profiling Identify
Specific Human Gut Microbiota and Metabolites Associated with Immune Checkpoint
Therapy Efficacy in Melanoma Patients
#MMPMID28923537
Frankel AE
; Coughlin LA
; Kim J
; Froehlich TW
; Xie Y
; Frenkel EP
; Koh AY
Neoplasia
2017[Oct]; 19
(10
): 848-855
PMID28923537
show ga
This is the first prospective study of the effects of human gut microbiota and
metabolites on immune checkpoint inhibitor (ICT) response in metastatic melanoma
patients. Whereas many melanoma patients exhibit profound response to ICT, there
are fewer options for patients failing ICT-particularly with BRAF-wild-type
disease. In preclinical studies, specific gut microbiota promotes regression of
melanoma in mice. We therefore conducted a study of the effects of pretreatment
gut microbiota and metabolites on ICT Response Evaluation Criteria in Solid
Tumors response in 39 metastatic melanoma patients treated with ipilimumab,
nivolumab, ipilimumab plus nivolumab (IN), or pembrolizumab (P). IN yielded 67%
responses and 8% stable disease; P achieved 23% responses and 23% stable disease.
ICT responders for all types of therapies were enriched for Bacteroides caccae.
Among IN responders, the gut microbiome was enriched for Faecalibacterium
prausnitzii, Bacteroides thetaiotamicron, and Holdemania filiformis. Among P
responders, the microbiome was enriched for Dorea formicogenerans. Unbiased
shotgun metabolomics revealed high levels of anacardic acid in ICT responders.
Based on these pilot studies, both additional confirmatory clinical studies and
preclinical testing of these bacterial species and metabolites are warranted to
confirm their ICT enhancing activity.
|*Gastrointestinal Microbiome
[MESH]
|*Metabolomics/methods
[MESH]
|*Metagenome
[MESH]
|*Metagenomics/methods
[MESH]
|Adult
[MESH]
|Aged
[MESH]
|Aged, 80 and over
[MESH]
|Antineoplastic Agents, Immunological/pharmacology/therapeutic use
[MESH]