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Takabe YJ, Allen E, Allen L, McCarthy R, Varma A, Bace M, Sharma P, Porter C, Yan L, Wu R, Bouchard RJ, Yendamuri S. Rothia in Nonsmall Cell Lung Cancer is Associated With Worse Survival. J Surg Res 2024; 296:106-114. [PMID: 38271794 DOI: 10.1016/j.jss.2023.12.026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2023] [Revised: 11/29/2023] [Accepted: 12/27/2023] [Indexed: 01/27/2024]
Abstract
INTRODUCTION The microbiome is known to play a significant role in cancer biology; however, few studies have elucidated its relationship with Nonsmall Cell Lung Cancer (NSCLC) patient outcomes. We hypothesized that there are specific microorganisms that are closely related with NSCLC patient survival. METHODS Total of 647 NSCLC (Adenocarcinoma and Squamous Cell Carcinoma combined) patients in The Cancer Genome Atlas (TCGA) were analyzed using the R software. RESULTS A Volcano Plot was analyzed with the patients divided into Short and Long Survivors by overall survival of 0.9 years, and we found that a bacterium Rothia was significantly abundant in Short Survivors, and Blastococcus, Leptospira, and Haematobacter in Long Survivors, but presence of Rothia alone was associated with overall survival. The age, race, subtype, and sex were not significantly different by the presence of Rothia in NSCLC. Unexpectedly, Rothia-positive NSCLC was associated with less cell proliferation by gene set enrichment analysis, Mki67 expression, proliferation score, with less fraction altered and homologous recombination deficiency, and with high infiltration of stromal cells, indicating favorable oncological characteristics. Further, Rothia-positive tumors were associated with significantly higher infiltration of CD8 T cells, CD4 T cells, Monocytes, and NK cells, and high interferon-gamma response, T-cell receptor richness, cytolytic activity, indicating favorable tumor immune microenvironment. CONCLUSIONS NSCLC with Rothia was associated with worse survival but also with favorable oncological characteristics such as less cell proliferation and favorable tumor immune microenvironment. We cannot help but speculate that Rothia in NSCLC is associated with mortality unrelated to oncological characteristics.
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Affiliation(s)
- Yamato J Takabe
- Department of Thoracic Surgery, Roswell Park Comprehensive Cancer Center, Buffalo, New York; Nichols High School, Buffalo, New York; Yale University, New Haven, Connecticut
| | | | | | | | | | | | | | | | - Li Yan
- Department of Biostatistics and Bioinformatics, Roswell Park Comprehensive Cancer Center, Buffalo, New York
| | - Rongrong Wu
- Department of Surgical Oncology, Roswell Park Comprehensive Cancer Center, Buffalo, New York
| | | | - Sai Yendamuri
- Department of Thoracic Surgery, Roswell Park Comprehensive Cancer Center, Buffalo, New York.
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LI B, HUANG Z, WANG Y, XUE J, XIA Y, XU Y, YANG H, LIANG N, LI S. [Relationship between Bacteria in the Lower Respiratory Tract/Lung Cancer
and the Development of Lung Cancer as well as Its Clinical Application]. ZHONGGUO FEI AI ZA ZHI = CHINESE JOURNAL OF LUNG CANCER 2024; 26:950-956. [PMID: 38163981 PMCID: PMC10767651 DOI: 10.3779/j.issn.1009-3419.2023.101.33] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 10/12/2023] [Indexed: 01/03/2024]
Abstract
Due to the advancement of 16S rRNA sequencing technology, the lower respiratory tract microbiota, which was considered non-existent, has been revealed. The correlation between these microorganisms and diseases such as tumor has been a hot topic in recent years. As the bacteria in the surrounding can infiltrate the tumors, researchers have also begun to pay attention to the biological behavior of tumor bacteria and their interaction with tumors. In this review, we present the characteristic of the lower respiratory tract bacteria and summarize recent research findings on the relationship between these microbiota and lung cancer. On top of that, we also summarize the basic feature of bacteria in tumors and focus on the characteristic of the bacteria in lung cancer. The relationship between bacteria in lung cancer and tumor development is also been discussed. Finally, we review the potential clinical applications of bacterial communities in the lower respiratory tract and lung cancer, and summarize key points of sample collection, sequencing, and contamination control, hoping to provide new ideas for the screening and treatment of tumors.
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Akashi Y, Yamamoto Y, Hashimoto M, Adomi S, Fujita K, Kiba K, Minami T, Yoshimura K, Hirayama A, Uemura H. Prognostic Factors of Platinum-Refractory Advanced Urothelial Carcinoma Treated with Pembrolizumab. Cancers (Basel) 2023; 15:5780. [PMID: 38136326 PMCID: PMC10742147 DOI: 10.3390/cancers15245780] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2023] [Revised: 12/06/2023] [Accepted: 12/06/2023] [Indexed: 12/24/2023] Open
Abstract
INTRODUCTION Immune checkpoint inhibitor (ICI) therapy has significantly improved the prognosis of some patients with advanced urothelial carcinoma (UC), but it does not provide high therapeutic efficacy in all patients. Therefore, identifying predictive biomarkers is crucial in determining which patients are candidates for ICI treatment. This study aimed to identify the predictors of ICI treatment response in patients with platinum-refractory advanced UC treated with pembrolizumab. METHODS Patients with platinum-refractory advanced UC who had received pembrolizumab at two hospitals in Japan were included. Univariate and multivariate analyses were performed to identify biomarkers for progression-free survival (PFS) and overall survival (OS). RESULTS Forty-one patients were evaluable for this analysis. Their median age was 75 years, and the vast majority of the patients were male (85.4%). The objective response rate was 29.3%, with a median overall survival (OS) of 17.8 months. On multivariate analysis, an Eastern Cooperative Oncology Group performance status (ECOG-PS) ≥ 2 (HR = 6.33, p = 0.03) and a baseline neutrophil-to-lymphocyte ratio (NLR) > 3 (HR = 2.79, p = 0.04) were significantly associated with poor OS. Antibiotic exposure did not have a significant impact on either PFS or OS. CONCLUSIONS ECOG-PS ≥ 2 and baseline NLR > 3 were independent risk factors for OS in patients with platinum-refractory advanced UC treated with pembrolizumab. Antibiotic exposure was not a predictor of ICI treatment response.
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Affiliation(s)
- Yasunori Akashi
- Department of Urology, Kindai University Nara Hospital, Ikoma 630-0293, Japan; (Y.A.)
| | - Yutaka Yamamoto
- Department of Urology, Kindai University Nara Hospital, Ikoma 630-0293, Japan; (Y.A.)
| | - Mamoru Hashimoto
- Department of Urology, Kindai University Hospital, Osakasayama 589-8511, Japan
| | - Shogo Adomi
- Department of Urology, Kindai University Hospital, Osakasayama 589-8511, Japan
| | - Kazutoshi Fujita
- Department of Urology, Kindai University Hospital, Osakasayama 589-8511, Japan
| | - Keisuke Kiba
- Department of Urology, Kindai University Nara Hospital, Ikoma 630-0293, Japan; (Y.A.)
| | - Takafumi Minami
- Department of Urology, Kindai University Hospital, Osakasayama 589-8511, Japan
| | - Kazuhiro Yoshimura
- Department of Urology, Kindai University Hospital, Osakasayama 589-8511, Japan
| | - Akihide Hirayama
- Department of Urology, Kindai University Nara Hospital, Ikoma 630-0293, Japan; (Y.A.)
| | - Hirotsugu Uemura
- Department of Urology, Kindai University Hospital, Osakasayama 589-8511, Japan
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Gonugunta AS, Von Itzstein MS, Hsiehchen D, Le T, Rashdan S, Yang H, Selby C, Alvarez C, Gerber DE. Antibiotic Prescriptions in Lung Cancer and Melanoma Populations: Differences With Potential Clinical Implications in the Immunotherapy Era. Clin Lung Cancer 2023; 24:11-17. [PMID: 36253271 DOI: 10.1016/j.cllc.2022.09.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2022] [Revised: 09/14/2022] [Accepted: 09/17/2022] [Indexed: 02/03/2023]
Abstract
INTRODUCTION Antibiotic exposure is associated with worse clinical outcomes in patients receiving immune checkpoint inhibitors (ICI). We analyzed antibiotic prescription patterns in lung cancer and melanoma, two malignancies in which ICI are used broadly across stages. METHODS We performed a retrospective cohort study of adults in the U.S. Veterans Affairs (VA) medical system diagnosed with lung cancer or melanoma from 2003 to 2016. We defined antibiotic exposure as receipt of a prescription for a systemic antibacterial agent between 6 months before and 6 months after cancer diagnosis. Demographics, clinical variables, prescriptions, and diagnostic codes were abstracted from the VA Corporate Data Warehouse. Antibiotic exposure was compared using t tests, Chi-square, and multivariate analyses. RESULTS A total of 310,321 patients (280,068 lung cancer, 30,253 melanoma) were included in the analysis. Antibiotic exposure was more common among patients with lung cancer (42% vs. 24% for melanoma; P < .001). Among antibiotic-exposed patients, those with lung cancer were more likely to receive prescriptions for multiple antibiotics (47% vs. 30% for melanoma; P < .001). In multivariate analyses, antibiotic exposure was associated with lung cancer diagnosis (HR 1.50; 95% CI, 1.46-1.55), comorbidity score (HR 1.08; 95% CI, 1.08-1.09), non-white race (HR 1.11; 95% CI, 1.06-1.17), and female gender (HR 1.31; 95% CI, 1.24-1.37). CONCLUSION Among cancer patients, antibiotics are prescribed frequently. Antibiotic exposure is more common in certain cancer types and patient populations. Given the negative effect antibiotic exposure has on immunotherapy outcomes, these observations may have clinical and healthy policy implications.
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Affiliation(s)
| | - Mitchell S Von Itzstein
- Department of Internal Medicine (Division of Hematology-Oncology), UT Southwestern Medical Center; Harold C. Simmons Comprehensive Cancer Center, UT Southwestern Medical Center
| | - David Hsiehchen
- Department of Internal Medicine (Division of Hematology-Oncology), UT Southwestern Medical Center; Harold C. Simmons Comprehensive Cancer Center, UT Southwestern Medical Center
| | - Tri Le
- Department of Internal Medicine (Division of Hematology-Oncology), UT Southwestern Medical Center; Harold C. Simmons Comprehensive Cancer Center, UT Southwestern Medical Center
| | - Sawsan Rashdan
- Department of Internal Medicine (Division of Hematology-Oncology), UT Southwestern Medical Center; Harold C. Simmons Comprehensive Cancer Center, UT Southwestern Medical Center
| | - Hui Yang
- Texas Tech University School of Pharmacy
| | | | - Carlos Alvarez
- Texas Tech University School of Pharmacy; Department of Population and Data Sciences, UT Southwestern Medical Center
| | - David E Gerber
- Department of Internal Medicine (Division of Hematology-Oncology), UT Southwestern Medical Center; Harold C. Simmons Comprehensive Cancer Center, UT Southwestern Medical Center; Department of Population and Data Sciences, UT Southwestern Medical Center.
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5
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Mino-Kenudson M, Schalper K, Cooper W, Dacic S, Hirsch FR, Jain D, Lopez-Rios F, Tsao MS, Yatabe Y, Beasley MB, Yu H, Sholl LM, Brambilla E, Chou TY, Connolly C, Wistuba I, Kerr KM, Lantuejoul S. Predictive Biomarkers for Immunotherapy in Lung Cancer: Perspective From the International Association for the Study of Lung Cancer Pathology Committee. J Thorac Oncol 2022; 17:1335-1354. [PMID: 36184066 DOI: 10.1016/j.jtho.2022.09.109] [Citation(s) in RCA: 52] [Impact Index Per Article: 26.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2022] [Revised: 09/08/2022] [Accepted: 09/12/2022] [Indexed: 10/14/2022]
Abstract
Immunotherapy including immune checkpoint inhibitors (ICIs) has become the backbone of treatment for most lung cancers with advanced or metastatic disease. In addition, they have increasingly been used for early stage tumors in neoadjuvant and adjuvant settings. Unfortunately, however, only a subset of patients experiences meaningful response to ICIs. Although programmed death-ligand 1 (PD-L1) protein expression by immunohistochemistry (IHC) has played a role as the principal predictive biomarker for immunotherapy, its performance may not be optimal, and it suffers multiple practical issues with different companion diagnostic assays approved. Similarly, tumor mutational burden (TMB) has multiple technical issues as a predictive biomarker for ICIs. Now, ongoing research on tumor- and host immune-specific factors has identified immunotherapy biomarkers that may provide better response and prognosis prediction, in particular in a multimodal approach. This review by the International Association for the Study of Lung Cancer Pathology Committee provides an overview of various immunotherapy biomarkers, including updated data on PD-L1 IHC and TMB, and assessments of neoantigens, genetic and epigenetic signatures, immune microenvironment by IHC and transcriptomics, and microbiome and pathologic response to neoadjuvant immunotherapies. The aim of this review is to underline the efficacy of new individual or combined predictive biomarkers beyond PD-L1 IHC and TMB.
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Affiliation(s)
- Mari Mino-Kenudson
- Department of Pathology, Massachusetts General Hospital & Harvard Medical School, Boston, Massachusetts
| | - Kurt Schalper
- Department of Pathology, Yale University School of Medicine, New Haven, Connecticut
| | - Wendy Cooper
- Royal Prince Alfred Hospital, NSW Health Pathology and University of Sydney, Camperdown, Australia
| | - Sanja Dacic
- Department of Pathology, Yale University School of Medicine, New Haven, Connecticut
| | - Fred R Hirsch
- Center for Thoracic Oncology, The Tisch Cancer Institute, New York, New York; Icahn School of Medicine, Mount Sinai Health System, New York, New York
| | - Deepali Jain
- All India Institute of Medical Sciences, New Delhi, India
| | - Fernando Lopez-Rios
- Department of Pathology, "Doce de Octubre" University Hospital, Madrid, Spain
| | - Ming Sound Tsao
- Princess Margaret Cancer Centre, University Health Network, Toronto, Ontario, Canada
| | | | - Mary Beth Beasley
- Icahn School of Medicine, Mount Sinai Health System, New York, New York
| | - Hui Yu
- Center for Thoracic Oncology, The Tisch Cancer Institute, New York, New York; Icahn School of Medicine, Mount Sinai Health System, New York, New York
| | - Lynette M Sholl
- Department of Pathology, Brigham and Women's Hospital & Harvard Medical School, Boston, Massachusetts
| | | | | | - Casey Connolly
- International Association for the Study of Lung Cancer, Denver, Colorado
| | - Ignacio Wistuba
- The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Keith M Kerr
- Department of Pathology, Aberdeen Royal Infirmary, Aberdeen, United Kingdom
| | - Sylvie Lantuejoul
- Université Grenoble Alpes, Grenoble, France; Centre Léon Bérard Unicancer, Lyon, France.
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6
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Yu J, Yin Y, Yu Y, Cheng M, Zhang S, Jiang S, Dong M. Effect of concomitant antibiotics use on patient outcomes and adverse effects in patients treated with ICIs. Immunopharmacol Immunotoxicol 2022; 45:386-394. [DOI: 10.1080/08923973.2022.2145966] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Affiliation(s)
- Jiuhang Yu
- College of Pharmacy, Jiamusi University, Jiamusi, China
- Department of Pharmacy, Harbin Medical University Cancer Hospital, Harbin, China
| | - Yichuang Yin
- College of Pharmacy, Jiamusi University, Jiamusi, China
- Department of Pharmacy, Harbin Medical University Cancer Hospital, Harbin, China
| | - Yang Yu
- Department of Pharmacy, Harbin Medical University Cancer Hospital, Harbin, China
| | - Mengfei Cheng
- Department of Pharmacy, Harbin Medical University Cancer Hospital, Harbin, China
| | - Shuo Zhang
- Department of Pharmacy, Harbin Medical University Cancer Hospital, Harbin, China
| | - Shuai Jiang
- Department of Pharmacy, Harbin Medical University Cancer Hospital, Harbin, China
| | - Mei Dong
- College of Pharmacy, Jiamusi University, Jiamusi, China
- Department of Pharmacy, Harbin Medical University Cancer Hospital, Harbin, China
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7
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Bou Zerdan M, Kassab J, Meouchy P, Haroun E, Nehme R, Bou Zerdan M, Fahed G, Petrosino M, Dutta D, Graziano S. The Lung Microbiota and Lung Cancer: A Growing Relationship. Cancers (Basel) 2022; 14:cancers14194813. [PMID: 36230736 PMCID: PMC9563611 DOI: 10.3390/cancers14194813] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2022] [Revised: 09/15/2022] [Accepted: 09/27/2022] [Indexed: 11/16/2022] Open
Abstract
Simple Summary In the past few years, the microbiota has emerged as a major player in cancer management. The efficacy of chemotherapy or immunotherapy may be influenced by the concomitant use of antibiotics before, during, or shortly after treatment with immune checkpoint inhibitors. Despite this, the mechanism linking the microbiota, host immunity, and malignancies are not clear, and the role of microbiota manipulation and analyses in cancer management is underway. In this manuscript, we discuss the role of the microbiota in the initiation, progression, and treatment outcomes of lung cancer. Abstract The lung is home to a dynamic microbial population crucial to modulating immune balance. Interest in the role of the lung microbiota in disease pathogenesis and treatment has exponentially increased. In lung cancer, early studies suggested an important role of dysbiosis in tumor initiation and progression. These results have helped accelerate research into the lung microbiota as a potential diagnostic marker and therapeutic target. Microbiota signatures could represent diagnostic biomarkers of early-stage disease. Lung microbiota research is in its infancy with a limited number of studies and only single-center studies with a significant methodological variation. Large, multicenter longitudinal studies are needed to establish the clinical potential of this exciting field.
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Affiliation(s)
- Maroun Bou Zerdan
- Department of Internal Medicine, SUNY Upstate Medical University, Syracuse, NY 13210, USA
- Department of Hematology and Oncology, Cleveland Clinic Florida, Weston, FL 33326, USA
| | - Joseph Kassab
- Faculty of Medicine, Saint-Joseph University, Beirut 11072180, Lebanon
| | - Paul Meouchy
- Department of Internal Medicine, Naef K. Basile Cancer Institute, American University of Beirut Medical Center, Beirut 11072020, Lebanon
| | - Elio Haroun
- Department of Medicine, Division of Hematology and Oncology, SUNY Upstate Medical University, Syracuse, NY 13210, USA
| | - Rami Nehme
- Department of Medicine, University of Pavia, 27100 Pavia, Italy
| | - Morgan Bou Zerdan
- Faculty of Medicine, American University of Beirut, Beirut 11072020, Lebanon
| | - Gracia Fahed
- Faculty of Medicine, American University of Beirut, Beirut 11072020, Lebanon
| | - Michael Petrosino
- Department of Internal Medicine, SUNY Upstate Medical University, Syracuse, NY 13210, USA
| | - Dibyendu Dutta
- Department of Medicine, Division of Hematology and Oncology, SUNY Upstate Medical University, Syracuse, NY 13210, USA
- Correspondence: (D.D.); (S.G.)
| | - Stephen Graziano
- Department of Medicine, Division of Hematology and Oncology, SUNY Upstate Medical University, Syracuse, NY 13210, USA
- Correspondence: (D.D.); (S.G.)
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Punekar SR, Shum E, Grello CM, Lau SC, Velcheti V. Immunotherapy in non-small cell lung cancer: Past, present, and future directions. Front Oncol 2022; 12:877594. [PMID: 35992832 PMCID: PMC9382405 DOI: 10.3389/fonc.2022.877594] [Citation(s) in RCA: 32] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2022] [Accepted: 06/24/2022] [Indexed: 11/13/2022] Open
Abstract
Many decades in the making, immunotherapy has demonstrated its ability to produce durable responses in several cancer types. In the last decade, immunotherapy has shown itself to be a viable therapeutic approach for non-small cell lung cancer (NSCLC). Several clinical trials have established the efficacy of immune checkpoint blockade (ICB), particularly in the form of anti-programmed death 1 (PD-1) antibodies, anti-cytotoxic T-lymphocyte-associated protein 4 (CTLA-4) antibodies and anti-programmed death 1 ligand (PD-L1) antibodies. Many trials have shown progression free survival (PFS) and overall survival (OS) benefit with either ICB alone or in combination with chemotherapy when compared to chemotherapy alone. The identification of biomarkers to predict response to immunotherapy continues to be evaluated. The future of immunotherapy in lung cancer continues to hold promise with the development of combination therapies, cytokine modulating therapies and cellular therapies. Lastly, we expect that innovative advances in technology, such as artificial intelligence (AI) and machine learning, will begin to play a role in the future care of patients with lung cancer.
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9
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Multi-Omics Approaches for the Prediction of Clinical Endpoints after Immunotherapy in Non-Small Cell Lung Cancer: A Comprehensive Review. Biomedicines 2022; 10:biomedicines10061237. [PMID: 35740259 PMCID: PMC9219996 DOI: 10.3390/biomedicines10061237] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2022] [Revised: 05/20/2022] [Accepted: 05/23/2022] [Indexed: 02/04/2023] Open
Abstract
Immune checkpoint inhibitors (ICI) have revolutionized the management of locally advanced and advanced non-small lung cancer (NSCLC). With an improvement in the overall survival (OS) as both first- and second-line treatments, ICIs, and especially programmed-death 1 (PD-1) and programmed-death ligands 1 (PD-L1), changed the landscape of thoracic oncology. The PD-L1 level of expression is commonly accepted as the most used biomarker, with both prognostic and predictive values. However, even in a low expression level of PD-L1, response rates remain significant while a significant number of patients will experience hyperprogression or adverse events. The dentification of such subtypes is thus of paramount importance. While several studies focused mainly on the prediction of the PD-L1 expression status, others aimed directly at the development of prediction/prognostic models. The response to ICIs depends on a complex physiopathological cascade, intricating multiple mechanisms from the molecular to the macroscopic level. With the high-throughput extraction of features, omics approaches aim for the most comprehensive assessment of each patient. In this article, we will review the place of the different biomarkers (clinical, biological, genomics, transcriptomics, proteomics and radiomics), their clinical implementation and discuss the most recent trends projecting on the future steps in prediction modeling in NSCLC patients treated with ICI.
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10
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Kloping YP, Hakim L. Prostate Cancer Microbiome: A Narrative Review of What We Know So Far. CURRENT CLINICAL MICROBIOLOGY REPORTS 2022. [DOI: 10.1007/s40588-022-00178-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Gebrayel P, Nicco C, Al Khodor S, Bilinski J, Caselli E, Comelli EM, Egert M, Giaroni C, Karpinski TM, Loniewski I, Mulak A, Reygner J, Samczuk P, Serino M, Sikora M, Terranegra A, Ufnal M, Villeger R, Pichon C, Konturek P, Edeas M. Microbiota medicine: towards clinical revolution. J Transl Med 2022; 20:111. [PMID: 35255932 PMCID: PMC8900094 DOI: 10.1186/s12967-022-03296-9] [Citation(s) in RCA: 85] [Impact Index Per Article: 42.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2022] [Accepted: 02/03/2022] [Indexed: 02/07/2023] Open
Abstract
The human gastrointestinal tract is inhabited by the largest microbial community within the human body consisting of trillions of microbes called gut microbiota. The normal flora is the site of many physiological functions such as enhancing the host immunity, participating in the nutrient absorption and protecting the body against pathogenic microorganisms. Numerous investigations showed a bidirectional interplay between gut microbiota and many organs within the human body such as the intestines, the lungs, the brain, and the skin. Large body of evidence demonstrated, more than a decade ago, that the gut microbial alteration is a key factor in the pathogenesis of many local and systemic disorders. In this regard, a deep understanding of the mechanisms involved in the gut microbial symbiosis/dysbiosis is crucial for the clinical and health field. We review the most recent studies on the involvement of gut microbiota in the pathogenesis of many diseases. We also elaborate the different strategies used to manipulate the gut microbiota in the prevention and treatment of disorders. The future of medicine is strongly related to the quality of our microbiota. Targeting microbiota dysbiosis will be a huge challenge.
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12
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von Itzstein MS, Gonugunta AS, Sheffield T, Homsi J, Dowell JE, Koh AY, Raj P, Fattah F, Wang Y, Basava VS, Khan S, Park JY, Popat V, Saltarski JM, Gloria-McCutchen Y, Hsiehchen D, Ostmeyer J, Xie Y, Li QZ, Wakeland EK, Gerber DE. Association between Antibiotic Exposure and Systemic Immune Parameters in Cancer Patients Receiving Checkpoint Inhibitor Therapy. Cancers (Basel) 2022; 14:1327. [PMID: 35267634 PMCID: PMC8909108 DOI: 10.3390/cancers14051327] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2022] [Revised: 02/28/2022] [Accepted: 03/02/2022] [Indexed: 01/19/2023] Open
Abstract
Antibiotic administration is associated with worse clinical outcomes and changes to the gut microbiome in cancer patients receiving immune checkpoint inhibitors (ICI). However, the effects of antibiotics on systemic immune function are unknown. We, therefore, evaluated antibiotic exposure, therapeutic responses, and multiplex panels of 40 serum cytokines and 124 antibodies at baseline and six weeks after ICI initiation, with p < 0.05 and false discovery rate (FDR) < 0.2 considered significant. A total of 251 patients were included, of whom the 135 (54%) who received antibiotics had lower response rates and shorter survival. Patients who received antibiotics prior to ICI initiation had modestly but significantly lower baseline levels of nucleolin, MDA5, c-reactive protein, and liver cytosol antigen type 1 (LC1) antibodies, as well as higher levels of heparin sulfate and Matrigel antibodies. After ICI initiation, antibiotic-treated patients had significantly lower levels of MDA5, CENP.B, and nucleolin antibodies. Although there were no clear differences in cytokines in the overall cohort, in the lung cancer subset (53% of the study population), we observed differences in IFN-γ, IL-8, and macrophage inflammatory proteins. In ICI-treated patients, antibiotic exposure is associated with changes in certain antibodies and cytokines. Understanding the relationship between these factors may improve the clinical management of patients receiving ICI.
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Affiliation(s)
- Mitchell S. von Itzstein
- Department of Internal Medicine, Division of Hematology-Oncology, University of Texas Southwestern Medical Center, Dallas, TX 75390, USA; (M.S.v.I.); (J.H.); (J.E.D.); (D.H.)
- Harold C. Simmons Comprehensive Cancer Center, University of Texas Southwestern Medical Center, Dallas, TX 75390, USA; (F.F.); (V.S.B.); (J.M.S.); (Y.G.-M.); (Y.X.)
| | - Amrit S. Gonugunta
- School of Medicine, University of Texas Southwestern Medical Center, Dallas, TX 75390, USA; (A.S.G.); (V.P.)
| | - Thomas Sheffield
- Department of Population and Data Sciences, University of Texas Southwestern Medical Center, Dallas, TX 75390, USA; (T.S.); (Y.W.); (J.O.)
| | - Jade Homsi
- Department of Internal Medicine, Division of Hematology-Oncology, University of Texas Southwestern Medical Center, Dallas, TX 75390, USA; (M.S.v.I.); (J.H.); (J.E.D.); (D.H.)
- Harold C. Simmons Comprehensive Cancer Center, University of Texas Southwestern Medical Center, Dallas, TX 75390, USA; (F.F.); (V.S.B.); (J.M.S.); (Y.G.-M.); (Y.X.)
| | - Jonathan E. Dowell
- Department of Internal Medicine, Division of Hematology-Oncology, University of Texas Southwestern Medical Center, Dallas, TX 75390, USA; (M.S.v.I.); (J.H.); (J.E.D.); (D.H.)
- Harold C. Simmons Comprehensive Cancer Center, University of Texas Southwestern Medical Center, Dallas, TX 75390, USA; (F.F.); (V.S.B.); (J.M.S.); (Y.G.-M.); (Y.X.)
| | - Andrew Y. Koh
- Department of Pediatrics, University of Texas Southwestern Medical Center, Dallas, TX 75390, USA;
| | - Prithvi Raj
- Department of Immunology, University of Texas Southwestern Medical Center, Dallas, TX 75390, USA; (P.R.); (S.K.); (Q.-Z.L.); (E.K.W.)
| | - Farjana Fattah
- Harold C. Simmons Comprehensive Cancer Center, University of Texas Southwestern Medical Center, Dallas, TX 75390, USA; (F.F.); (V.S.B.); (J.M.S.); (Y.G.-M.); (Y.X.)
| | - Yiqing Wang
- Department of Population and Data Sciences, University of Texas Southwestern Medical Center, Dallas, TX 75390, USA; (T.S.); (Y.W.); (J.O.)
| | - Vijay S. Basava
- Harold C. Simmons Comprehensive Cancer Center, University of Texas Southwestern Medical Center, Dallas, TX 75390, USA; (F.F.); (V.S.B.); (J.M.S.); (Y.G.-M.); (Y.X.)
| | - Shaheen Khan
- Department of Immunology, University of Texas Southwestern Medical Center, Dallas, TX 75390, USA; (P.R.); (S.K.); (Q.-Z.L.); (E.K.W.)
| | - Jason Y. Park
- Department of Pathology, University of Texas Southwestern Medical Center, Dallas, TX 75390, USA;
| | - Vinita Popat
- School of Medicine, University of Texas Southwestern Medical Center, Dallas, TX 75390, USA; (A.S.G.); (V.P.)
| | - Jessica M. Saltarski
- Harold C. Simmons Comprehensive Cancer Center, University of Texas Southwestern Medical Center, Dallas, TX 75390, USA; (F.F.); (V.S.B.); (J.M.S.); (Y.G.-M.); (Y.X.)
| | - Yvonne Gloria-McCutchen
- Harold C. Simmons Comprehensive Cancer Center, University of Texas Southwestern Medical Center, Dallas, TX 75390, USA; (F.F.); (V.S.B.); (J.M.S.); (Y.G.-M.); (Y.X.)
| | - David Hsiehchen
- Department of Internal Medicine, Division of Hematology-Oncology, University of Texas Southwestern Medical Center, Dallas, TX 75390, USA; (M.S.v.I.); (J.H.); (J.E.D.); (D.H.)
- Harold C. Simmons Comprehensive Cancer Center, University of Texas Southwestern Medical Center, Dallas, TX 75390, USA; (F.F.); (V.S.B.); (J.M.S.); (Y.G.-M.); (Y.X.)
| | - Jared Ostmeyer
- Department of Population and Data Sciences, University of Texas Southwestern Medical Center, Dallas, TX 75390, USA; (T.S.); (Y.W.); (J.O.)
| | - Yang Xie
- Harold C. Simmons Comprehensive Cancer Center, University of Texas Southwestern Medical Center, Dallas, TX 75390, USA; (F.F.); (V.S.B.); (J.M.S.); (Y.G.-M.); (Y.X.)
- Department of Population and Data Sciences, University of Texas Southwestern Medical Center, Dallas, TX 75390, USA; (T.S.); (Y.W.); (J.O.)
| | - Quan-Zhen Li
- Department of Immunology, University of Texas Southwestern Medical Center, Dallas, TX 75390, USA; (P.R.); (S.K.); (Q.-Z.L.); (E.K.W.)
| | - Edward K. Wakeland
- Department of Immunology, University of Texas Southwestern Medical Center, Dallas, TX 75390, USA; (P.R.); (S.K.); (Q.-Z.L.); (E.K.W.)
| | - David E. Gerber
- Department of Internal Medicine, Division of Hematology-Oncology, University of Texas Southwestern Medical Center, Dallas, TX 75390, USA; (M.S.v.I.); (J.H.); (J.E.D.); (D.H.)
- Harold C. Simmons Comprehensive Cancer Center, University of Texas Southwestern Medical Center, Dallas, TX 75390, USA; (F.F.); (V.S.B.); (J.M.S.); (Y.G.-M.); (Y.X.)
- Department of Population and Data Sciences, University of Texas Southwestern Medical Center, Dallas, TX 75390, USA; (T.S.); (Y.W.); (J.O.)
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13
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McLean AEB, Kao SC, Barnes DJ, Wong KKH, Scolyer RA, Cooper WA, Kohonen-Corish MRJ. The emerging role of the lung microbiome and its importance in non-small cell lung cancer diagnosis and treatment. Lung Cancer 2022; 165:124-132. [PMID: 35123155 DOI: 10.1016/j.lungcan.2022.01.011] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2021] [Revised: 01/11/2022] [Accepted: 01/15/2022] [Indexed: 12/18/2022]
Abstract
Over the last 10 years, with the development of culture-free bacterial identification techniques, understanding of how the microbiome influences diseases has increased exponentially and has highlighted potential opportunities for its use as a diagnostic biomarker and interventional target in many diseases including malignancy. Initial research focused on the faecal microbiome since it contains the densest bacterial populations and many other mucosal sites, such as the lungs, were until recently thought to be sterile. However, in recent years, it has become clear that the lower airways are home to a dynamic bacterial population sustained by the migration and elimination of microbes from the gastrointestinal and upper airway tracts. As in the gut, the lung microbiome plays an important role in regulating mucosal immunity and maintaining the balance between immune tolerance and inflammation. Studies to date have all shown that the lung microbiome undergoes significant changes in the setting of pulmonary disease. In lung cancer, animal models and small patient cohort studies have suggested that microbiome dysbiosis may not only impact tumour progression and response to therapy, particularly immunotherapy, but also plays a key role in cancer pathogenesis by influencing early carcinogenic pathways. These early results have led to concerted efforts to identify microbiome signatures that represent diagnostic biomarkers of early-stage disease and to consider modulation of the lung microbiome as a potential therapeutic strategy. Lung microbiome research is in its infancy and studies to date have been small, single centre with significant methodological variation. Large, multicentre longitudinal studies are needed to establish the clinical potential of this exciting field.
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Affiliation(s)
- Anna E B McLean
- Faculty of Medicine and Health Sciences, The University of Sydney, Camperdown, New South Wales, Australia; Respiratory and Sleep Medicine, Sydney Local Health District, Royal Prince Alfred Hospital, Camperdown, New South Wales, Australia; Woolcock Institute of Medical Research, Glebe, New South Wales, Australia.
| | - Steven C Kao
- Faculty of Medicine and Health Sciences, The University of Sydney, Camperdown, New South Wales, Australia; Department of Medical Oncology, Chris O'Brien Lifehouse, Camperdown, Australia; Asbestos Diseases Research Institute, Rhodes, Australia
| | - David J Barnes
- Faculty of Medicine and Health Sciences, The University of Sydney, Camperdown, New South Wales, Australia; Respiratory and Sleep Medicine, Sydney Local Health District, Royal Prince Alfred Hospital, Camperdown, New South Wales, Australia
| | - Keith K H Wong
- Faculty of Medicine and Health Sciences, The University of Sydney, Camperdown, New South Wales, Australia; Respiratory and Sleep Medicine, Sydney Local Health District, Royal Prince Alfred Hospital, Camperdown, New South Wales, Australia; Woolcock Institute of Medical Research, Glebe, New South Wales, Australia
| | - Richard A Scolyer
- Faculty of Medicine and Health Sciences, The University of Sydney, Camperdown, New South Wales, Australia; Tissue Pathology and Diagnostic Oncology, Sydney Local Health District, Royal Prince Alfred Hospital, Camperdown, New South Wales, Australia; Charles Perkins Centre, The University of Sydney, Sydney, NSW, Australia; Melanoma Institute Australia, The University of Sydney, North Sydney, NSW, Australia
| | - Wendy A Cooper
- Faculty of Medicine and Health Sciences, The University of Sydney, Camperdown, New South Wales, Australia; Tissue Pathology and Diagnostic Oncology, Sydney Local Health District, Royal Prince Alfred Hospital, Camperdown, New South Wales, Australia; Western Sydney University, Campbelltown, Sydney, New South Wales, Australia
| | - Maija R J Kohonen-Corish
- Woolcock Institute of Medical Research, Glebe, New South Wales, Australia; Western Sydney University, Campbelltown, Sydney, New South Wales, Australia; University of Technology Sydney, Ultimo, New South Wales, Australia; Microbiome Research Centre, St George and Sutherland Clinical School, UNSW Sydney, Kogarah, New South Wales, Australia
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14
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Augustus E, Zwaenepoel K, Siozopoulou V, Raskin J, Jordaens S, Baggerman G, Sorber L, Roeyen G, Peeters M, Pauwels P. Prognostic and Predictive Biomarkers in Non-Small Cell Lung Cancer Patients on Immunotherapy-The Role of Liquid Biopsy in Unraveling the Puzzle. Cancers (Basel) 2021; 13:1675. [PMID: 33918147 PMCID: PMC8036384 DOI: 10.3390/cancers13071675] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2021] [Revised: 03/29/2021] [Accepted: 03/30/2021] [Indexed: 12/14/2022] Open
Abstract
In the last decade, immunotherapy has been one of the most important advances in the non-small cell lung cancer (NSCLC) treatment landscape. Nevertheless, only a subset of NSCLC patients benefits from it. Currently, the only Food and Drug Administration (FDA) approved diagnostic test for first-line immunotherapy in metastatic NSCLC patients uses tissue biopsies to determine the programmed death ligand 1 (PD-L1) status. However, obtaining tumor tissue is not always feasible and puts the patient at risk. Liquid biopsy, which refers to the tumor-derived material present in body fluids, offers an alternative approach. This less invasive technique gives real-time information on the tumor characteristics. This review addresses different promising liquid biopsy based biomarkers in NSCLC patients that enable the selection of patients who benefit from immunotherapy and the monitoring of patients during this therapy. The challenges and the opportunities of blood-based biomarkers such as cell-free DNA (cfDNA), circulating tumor cells (CTCs), exosomes, epigenetic signatures, microRNAs (miRNAs) and the T cell repertoire will be addressed. This review also focuses on the less-studied feces-based and breath-based biomarkers.
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Affiliation(s)
- Elien Augustus
- Center for Oncological Research Antwerp (CORE), Integrated Personalized & Precision Oncology Network (IPPON), University of Antwerp (UAntwerp), 2610 Wilrijk, Belgium; (K.Z.); (V.S.); (S.J.); (L.S.); (M.P.); (P.P.)
- Laboratory of Pathological Anatomy, Antwerp University Hospital (UZA), 2650 Edegem, Belgium
| | - Karen Zwaenepoel
- Center for Oncological Research Antwerp (CORE), Integrated Personalized & Precision Oncology Network (IPPON), University of Antwerp (UAntwerp), 2610 Wilrijk, Belgium; (K.Z.); (V.S.); (S.J.); (L.S.); (M.P.); (P.P.)
- Laboratory of Pathological Anatomy, Antwerp University Hospital (UZA), 2650 Edegem, Belgium
| | - Vasiliki Siozopoulou
- Center for Oncological Research Antwerp (CORE), Integrated Personalized & Precision Oncology Network (IPPON), University of Antwerp (UAntwerp), 2610 Wilrijk, Belgium; (K.Z.); (V.S.); (S.J.); (L.S.); (M.P.); (P.P.)
- Laboratory of Pathological Anatomy, Antwerp University Hospital (UZA), 2650 Edegem, Belgium
| | - Jo Raskin
- Department of Pulmonology and Thoracic Oncology, Antwerp University Hospital (UZA), 2650 Edegem, Belgium;
| | - Stephanie Jordaens
- Center for Oncological Research Antwerp (CORE), Integrated Personalized & Precision Oncology Network (IPPON), University of Antwerp (UAntwerp), 2610 Wilrijk, Belgium; (K.Z.); (V.S.); (S.J.); (L.S.); (M.P.); (P.P.)
- Laboratory of Pathological Anatomy, Antwerp University Hospital (UZA), 2650 Edegem, Belgium
| | - Geert Baggerman
- Centre for Proteomics, University of Antwerp (UAntwerp), 2020 Antwerpen, Belgium;
- Health Unit, Vlaamse Instelling voor Technologisch Onderzoek (VITO), 2400 Mol, Belgium
| | - Laure Sorber
- Center for Oncological Research Antwerp (CORE), Integrated Personalized & Precision Oncology Network (IPPON), University of Antwerp (UAntwerp), 2610 Wilrijk, Belgium; (K.Z.); (V.S.); (S.J.); (L.S.); (M.P.); (P.P.)
- Laboratory of Pathological Anatomy, Antwerp University Hospital (UZA), 2650 Edegem, Belgium
| | - Geert Roeyen
- Department of Hepato-Pancreato-Biliary, Endocrine and Transplantation Surgery, Antwerp University Hospital (UZA), 2650 Edegem, Belgium;
| | - Marc Peeters
- Center for Oncological Research Antwerp (CORE), Integrated Personalized & Precision Oncology Network (IPPON), University of Antwerp (UAntwerp), 2610 Wilrijk, Belgium; (K.Z.); (V.S.); (S.J.); (L.S.); (M.P.); (P.P.)
- Department of Oncology, Multidisciplinary Oncological Center Antwerp, Antwerp University Hospital (UZA), 2650 Edegem, Belgium
| | - Patrick Pauwels
- Center for Oncological Research Antwerp (CORE), Integrated Personalized & Precision Oncology Network (IPPON), University of Antwerp (UAntwerp), 2610 Wilrijk, Belgium; (K.Z.); (V.S.); (S.J.); (L.S.); (M.P.); (P.P.)
- Laboratory of Pathological Anatomy, Antwerp University Hospital (UZA), 2650 Edegem, Belgium
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