Gut microbiome predicts gastrointestinal toxicity outcomes from chemoradiation therapy in patients with head and neck squamous cell carcinoma

From BugSigDB
Reviewed Marked as Reviewed by Chloe on 2024-1-4
study design
Citation
PMID PubMed identifier for scientific articles.
DOI Digital object identifier for electronic documents.
Authors
Hes C, Desilets A, Tonneau M, El Ouarzadi O, De Figueiredo Sousa M, Bahig H, Filion É, Nguyen-Tan PF, Christopoulos A, Benlaïfaoui M, Derosa L, Alves Costa Silva C, Ponce M, Malo J, Belkad W, Charpentier D, Aubin F, Hamilou Z, Jamal R, Messaoudene M, Soulières D, Routy B
Journal
Oral oncology
Year
2023
Keywords:
Chemoradiation therapy, Head and neck squamous cell cancer, Microbiome, Mucositis
OBJECTIVES: Chemoradiation (CRT) in patients with locally advanced head and neck squamous cell cancer (HNSCC) is associated with significant toxicities, including mucositis. The gut microbiome represents an emerging hallmark of cancer and a potentially important biomarker for CRT-related adverse events. This prospective study investigated the association between the gut microbiome composition and CRT-related toxicities in patients with HNSCC, including mucositis. MATERIALS AND METHODS: Stool samples from patients diagnosed with locally advanced HNSCC were prospectively collected prior to CRT initiation and analyzed using shotgun metagenomic sequencing to evaluate gut microbiome composition at baseline. Concurrently, clinicopathologic data, survival outcomes and the incidence and grading of CRT-emergent adverse events were documented in all patients. RESULTS: A total of 52 patients were included, of whom 47 had baseline stool samples available for metagenomic analysis. Median age was 62, 83 % patients were men and 54 % had stage III-IV disease. All patients developed CRT-induced mucositis, including 42 % with severe events (i.e. CTCAE v5.0 grade ≥ 3) and 25 % who required enteral feeding. With a median follow-up of 26.5 months, patients with severe mucositis had shorter overall survival (HR = 3.3, 95 %CI 1.0-10.6; p = 0.02) and numerically shorter progression-free survival (HR = 2.8, 95 %CI, 0.8-9.6; p = 0.09). The gut microbiome beta-diversity of patients with severe mucositis differed from patients with grades 1-2 mucositis (p = 0.04), with enrichment in Mediterraneibacter (Ruminococcus gnavus) and Clostridiaceae family members, including Hungatella hathewayi. Grade 1-2 mucositis was associated with enrichment in Eubacterium rectale, Alistipes putredinis and Ruminococcaceae family members. Similar bacterial profiles were observed in patients who required enteral feeding. CONCLUSION: Patients who developed severe mucositis had decreased survival and enrichment in specific bacteria associated with mucosal inflammation. Interestingly, these same bacteria have been linked to immune checkpoint inhibitor resistance.

Experiment 1


Reviewed Marked as Reviewed by Chloe on 2024-1-4

Curated date: 2023/12/20

Curator: Andre

Revision editor(s): Andre, Chloe

Subjects

Location of subjects
Canada
Host species Species from which microbiome was sampled. Contact us to have more species added.
Homo sapiens
Body site Anatomical site where microbial samples were extracted from according to the Uber Anatomy Ontology
Feces Cow dung,Cow pat,Droppings,Dung,Excrement,Excreta,Faeces,Fecal material,Fecal matter,Fewmet,Frass,Guano,Matières fécales@fr,Merde@fr,Ordure,Partie de la merde@fr,Piece of shit,Porción de mierda@es,Portion of dung,Portion of excrement,Portion of faeces,Portion of fecal material,Portion of fecal matter,Portion of feces,Portion of guano,Portion of scat,Portionem cacas,Scat,Spoor,Spraint,Stool,Teil der fäkalien@de,Feces,feces
Condition The experimental condition / phenotype studied according to the Experimental Factor Ontology
Head and neck squamous cell carcinoma carcinoma of the head and neck,craniocervical region squamous cell carcinoma,head and neck squamous cell carcinoma,HNSCC,SCCHN,squamous cell carcinoma of head and neck,squamous cell carcinoma of the head and neck,squamous cell carcinoma, head and neck,squamous cell carcinomas of head and neck,Head and neck squamous cell carcinoma
Group 0 name Corresponds to the control (unexposed) group for case-control studies
Oral mucositis CTCAE grade 1-2 (mild)
Group 1 name Corresponds to the case (exposed) group for case-control studies
Oral mucositis CTCAE grade 3 (severe)
Group 1 definition Diagnostic criteria applied to define the specific condition / phenotype represented in the case (exposed) group
Patients with severe mucositis following chemoradiation therapy
Group 0 sample size Number of subjects in the control (unexposed) group
30
Group 1 sample size Number of subjects in the case (exposed) group
22

Lab analysis

Sequencing type
WMS
16S variable region One or more hypervariable region(s) of the bacterial 16S gene
Not specified
Sequencing platform Manufacturer and experimental platform used for quantifying microbial abundance
Illumina

Statistical Analysis

Data transformation Data transformation applied to microbial abundance measurements prior to differential abundance testing (if any).
relative abundances
Statistical test
LEfSe
Significance threshold p-value or FDR threshold used for differential abundance testing (if any)
0.05
LDA Score above Threshold for the linear discriminant analysis (LDA) score for studies using the popular LEfSe tool
2

Alpha Diversity

Richness Number of species
unchanged

Signature 1

Reviewed Marked as Reviewed by Chloe on 2024-1-4

Curated date: 2023/12/20

Curator: Andre

Revision editor(s): Andre

Source: Fig. 2.

Description: Fig. 2. Gut microbiome profiling with shotgun metagenomic sequencing by development of severe mucositis

Abundance in Group 1: increased abundance in Oral mucositis CTCAE grade 3 (severe)

NCBI Quality ControlLinks
Anaerostipes caccae
Clostridia bacterium UC5.1-1D1
Clostridium paraputrificum
Enterocloster clostridioformis
Hungatella hathewayi
Massilicoli timonensis
Massilimicrobiota timonensis
Mediterraneibacter gnavus
Ruthenibacterium lactatiformans
Sellimonas intestinalis
Thomasclavelia ramosa
clostridiaceae_GGB9580_SGB14998clostridiaceae_GGB9580_SGB14998
lachnospiraceae_bacterium_NSJ_29lachnospiraceae_bacterium_NSJ_29

Revision editor(s): Andre

Signature 2

Reviewed Marked as Reviewed by Chloe on 2024-1-4

Curated date: 2023/12/20

Curator: Andre

Revision editor(s): Andre

Source: Fig. 2

Description: Fig. 2. Gut microbiome profiling with shotgun metagenomic sequencing by development of severe mucositis

Abundance in Group 1: decreased abundance in Oral mucositis CTCAE grade 3 (severe)

NCBI Quality ControlLinks
Agathobacter rectalis
Alistipes putredinis
Alistipes senegalensis
Alloscardovia omnicolens
Clostridiales bacterium KLE1615
Clostridium sp. AF34-10BH
Clostridium sp. chh4-2
Lachnospira pectinoschiza
Phocaeicola massiliensis
Prevotella marseillensis
Senegalimassilia anaerobia
[Ruminococcus] lactaris
Desulfovibrionaceae bacterium
FGB9370_GGB51959_SGB72479FGB9370_GGB51959_SGB72479
Clostridia_unclassified_GGB9774_SGB15394Clostridia_unclassified_GGB9774_SGB15394
Ruminococcaceae_GGB9621_SGB15073Ruminococcaceae_GGB9621_SGB15073
Clostridia_unclassified_GGB4566_SGB6305Clostridia_unclassified_GGB4566_SGB6305
Clostridiaceae_GGB3478_SGB4643Clostridiaceae_GGB3478_SGB4643
Ruminococcaceae_GGB9615_SGB15053Ruminococcaceae_GGB9615_SGB15053
lachnopiraceae_bacterium_WCA3_601_WT_6Hlachnopiraceae_bacterium_WCA3_601_WT_6H
Gemmiger_SGB15299Gemmiger_SGB15299
Ruminococcaceae_GGB9633_SGB15091Ruminococcaceae_GGB9633_SGB15091
anaerosacchariphilus_sp_NSJ_68anaerosacchariphilus_sp_NSJ_68

Revision editor(s): Andre

Experiment 2


Reviewed Marked as Reviewed by Chloe on 2024-1-4

Curated date: 2024/01/03

Curator: Andre

Revision editor(s): Andre, Chloe

Differences from previous experiment shown

Subjects

Group 0 name Corresponds to the control (unexposed) group for case-control studies
No enteral feeding plus mild mucositis
Group 1 name Corresponds to the case (exposed) group for case-control studies
Enteral feeding plus mucositis of any grade
Group 1 definition Diagnostic criteria applied to define the specific condition / phenotype represented in the case (exposed) group
Head and neck squamous cell carcinoma with severe mucositis and enteral feeding need
Group 0 sample size Number of subjects in the control (unexposed) group
27
Group 1 sample size Number of subjects in the case (exposed) group
13

Lab analysis

Statistical Analysis

Alpha Diversity

Richness Number of species
unchanged

Signature 1

Reviewed Marked as Reviewed by Chloe on 2024-1-4

Curated date: 2024/01/03

Curator: Andre

Revision editor(s): Andre

Source: Fig 3

Description: Gut microbiome profiling with shotgun metagenomic sequencing by co-occurrence of development of severe mucositis and enteral feeding

Abundance in Group 1: increased abundance in Enteral feeding plus mucositis of any grade

NCBI Quality ControlLinks
Anaerostipes caccae
Eggerthella sp. YY7918
Enterocloster clostridioformis
Enterococcus faecalis
Kytococcus sedentarius
Lachnoclostridium sp. An181
Mediterraneibacter gnavus
Ruthenibacterium lactatiformans
Sellimonas intestinalis
Thomasclavelia ramosa
[Clostridium] innocuum
Lachnospiraceae_bacterium_NSJ_29Lachnospiraceae_bacterium_NSJ_29

Revision editor(s): Andre

Signature 2

Reviewed Marked as Reviewed by Chloe on 2024-1-4

Curated date: 2024/01/03

Curator: Andre

Revision editor(s): Andre

Source: Fig3.

Description:

Abundance in Group 1: decreased abundance in Enteral feeding plus mucositis of any grade

NCBI Quality ControlLinks
Alistipes putredinis
Blautia obeum
Clostridiales bacterium KLE1615
Clostridium sp. AF34-10BH
Coprococcus catus
Dorea formicigenerans
Eubacterium ventriosum
Phocaeicola dorei
Phocaeicola massiliensis
Roseburia intestinalis
Senegalimassilia anaerobia
Sutterella wadsworthensis
Lachnopiraceae_bacterium_WCA3_601_WT_6HLachnopiraceae_bacterium_WCA3_601_WT_6H
Clostridia_unclassified_GGB9758_SGB15368Clostridia_unclassified_GGB9758_SGB15368
Ruminococcaceae_GGB9615_SGB15053Ruminococcaceae_GGB9615_SGB15053
Claustridium_sp_AF20_17LBClaustridium_sp_AF20_17LB
Lachnospiraceae_GGB3523_SGB4703Lachnospiraceae_GGB3523_SGB4703
Blautia_SGB4831Blautia_SGB4831
Gemmiger_SGB15299Gemmiger_SGB15299
FGB9370_GGB51959_SGB72479FGB9370_GGB51959_SGB72479

Revision editor(s): Andre

Experiment 3


Reviewed Marked as Reviewed by Chloe on 2024-1-4

Curated date: 2024/01/03

Curator: Andre

Revision editor(s): Andre, Chloe

Differences from previous experiment shown

Subjects

Group 0 name Corresponds to the control (unexposed) group for case-control studies
No Enteral feeding tube placement
Group 1 name Corresponds to the case (exposed) group for case-control studies
Enteral feeding tube placement
Group 1 definition Diagnostic criteria applied to define the specific condition / phenotype represented in the case (exposed) group
Patients needing enteral feeding

Lab analysis

Statistical Analysis

Alpha Diversity

Richness Number of species
unchanged

Signature 1

Reviewed Marked as Reviewed by Chloe on 2024-1-4

Curated date: 2024/01/03

Curator: Andre

Revision editor(s): Andre

Source: Supplemental Figure 10

Description: Gut microbiome profiling in patients with enteral feeding versus without

Abundance in Group 1: increased abundance in Enteral feeding tube placement

NCBI Quality ControlLinks
Anaerostipes caccae
Blautia hansenii
Blautia producta
Eggerthella sp. YY7918
Eisenbergiella sp. OF01-20
Enterocloster clostridioformis
Enterococcus faecalis
Faecalicatena contorta
Faecalimonas umbilicata
Isoptericola variabilis
Kytococcus sedentarius
Lachnoclostridium sp. An181
Mediterraneibacter gnavus
Ruthenibacterium lactatiformans
Thomasclavelia ramosa
Veillonella parvula
[Clostridium] innocuum
Microbacterium_SGB53518Microbacterium_SGB53518
Clostridia_unclassified_GGB9348_SGB14315Clostridia_unclassified_GGB9348_SGB14315
Lachnospiraceae_bacterium_NSJ_29Lachnospiraceae_bacterium_NSJ_29
Clostridiaceae_GGB4482_SGB6177Clostridiaceae_GGB4482_SGB6177
FGB4549_GGB55957_SGB77276FGB4549_GGB55957_SGB77276
Clostridia_unclassified_GGB9532_SGB14933Clostridia_unclassified_GGB9532_SGB14933

Revision editor(s): Andre

Signature 2

Reviewed Marked as Reviewed by Chloe on 2024-1-4

Curated date: 2024/01/03

Curator: Andre

Revision editor(s): Andre

Source: Supplemental Figure 10

Description: Gut microbiome profiling in patients with enteral feeding versus without

Abundance in Group 1: decreased abundance in Enteral feeding tube placement

NCBI Quality ControlLinks
Alistipes putredinis
Blautia obeum
Butyricimonas faecihominis
Clostridiales bacterium KLE1615
Clostridium sp. AF34-10BH
Coprococcus catus
Dorea formicigenerans
Dorea sp. AF36-15AT
Eubacterium ventriosum
Faecalicatena fissicatena
Phocaeicola dorei
Phocaeicola massiliensis
Roseburia intestinalis
Ruminococcaceae_GGB9619_SGB15067Ruminococcaceae_GGB9619_SGB15067
Ruminococcaceae_GGB9621_SGB15073Ruminococcaceae_GGB9621_SGB15073
Lachnospiraceae_GGB3523_SGB4703Lachnospiraceae_GGB3523_SGB4703
FGB9370_GGB51959_SGB72479FGB9370_GGB51959_SGB72479
Alphaproteobacteria_unclassified_GGB6612_SGB934Alphaproteobacteria_unclassified_GGB6612_SGB934
FGB11737_GGB34228_SGB72916FGB11737_GGB34228_SGB72916
Ruminococcaceae_GGB9615_SGB15053Ruminococcaceae_GGB9615_SGB15053
Blautia_SGB4831Blautia_SGB4831
Clostridia unclassified_GGB9758_SGB15368Clostridia unclassified_GGB9758_SGB15368
Lachnospiraceae bacterium_WCA3_601_WT_6HLachnospiraceae bacterium_WCA3_601_WT_6H
Gemmiger_SGB15299Gemmiger_SGB15299

Revision editor(s): Andre