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Multi-omics of the gut microbial ecosystem in patients with microsatellite-instability-high gastrointestinal cancer resistant to immunotherapy.


ABSTRACT: Despite the encouraging efficacy of anti-PD-1/PD-L1 immunotherapy in microsatellite-instability-high/deficient mismatch repair (MSI-H/dMMR) advanced gastrointestinal cancer, many patients exhibit primary or acquired resistance. Using multi-omics approaches, we interrogate gut microbiome, blood metabolome, and cytokines/chemokines of patients with MSI-H/dMMR gastrointestinal cancer (N = 77) at baseline and during the treatment. We identify a number of microbes (e.g., Porphyromonadaceae) and metabolites (e.g., arginine) highly associated with primary resistance to immunotherapy. An independent validation cohort (N = 39) and mouse model are used to further confirm our findings. A predictive machine learning model for primary resistance is also built and achieves an accuracy of 0.79 on the external validation set. Furthermore, several microbes are pinpointed that gradually changed during the process of acquired resistance. In summary, our study demonstrates the essential role of gut microbiome in drug resistance, and this can be utilized as a preventative diagnosis tool and therapeutic target in the future.

SUBMITTER: Cheng S 

PROVIDER: S-EPMC10829783 | biostudies-literature | 2024 Jan

REPOSITORIES: biostudies-literature

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Multi-omics of the gut microbial ecosystem in patients with microsatellite-instability-high gastrointestinal cancer resistant to immunotherapy.

Cheng Siyuan S   Han Zihan Z   Dai Die D   Li Fang F   Zhang Xiaotian X   Lu Ming M   Lu Zhihao Z   Wang Xicheng X   Zhou Jun J   Li Jian J   Guo Xiaohuan X   Song Panwei P   Qiu Chuangzhao C   Shen Wei W   Zhang Qi Q   Zhu Ning N   Wang Xi X   Tan Yan Y   Kou Yan Y   Yin Xiaochen X   Shen Lin L   Peng Zhi Z  

Cell reports. Medicine 20240108 1


Despite the encouraging efficacy of anti-PD-1/PD-L1 immunotherapy in microsatellite-instability-high/deficient mismatch repair (MSI-H/dMMR) advanced gastrointestinal cancer, many patients exhibit primary or acquired resistance. Using multi-omics approaches, we interrogate gut microbiome, blood metabolome, and cytokines/chemokines of patients with MSI-H/dMMR gastrointestinal cancer (N = 77) at baseline and during the treatment. We identify a number of microbes (e.g., Porphyromonadaceae) and metab  ...[more]

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