AACR 2019—Probiotics tied to poor immunotherapy response in melanoma


  • Keren Landman, MD
  • Univadis
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Takeaway

  • The gut microbiome (GM) in patients with melanoma may be negatively influenced by probiotics and could be targeted by dietary manipulation.

Why this matters

  • A favorable GM signature is associated with anti-programmed cell death 1 (anti-PD-1) therapy in melanoma, but it is unclear how diet and probiotic use influence this relationship.

Study design

  • An analysis of data from 113 patients with melanoma who prospectively provided pretreatment stool samples and completed a National Cancer Institute lifestyle diet questionnaire.
  • Stool samples were subjected to 16S rRNA sequencing, and GM alpha- and beta-diversity (AD and BD, respectively, associated with response and nonresponse to anti-PD-1 therapy) was compared.
  • Response to anti-PD-1 therapy was defined per RECIST criteria.
  • Funding: Melanoma Research Alliance, MD Anderson, Mulva Research Fund, Adelson Medical Research Foundation.

Key results

  • Reported probiotic use (42%) was associated with lower AD (P=.05) and poorer response to anti-PD-1 therapy (OR 0.36 [95% CI, 0.10-1.31]).
  • Patients with a high-fiber diet had higher odds of response (OR 4.78 [95% CI, 1.1-20.3]).
  • Higher intake of whole grains, fruits, vegetables, and fiber correlated positively with proresponse bacterial populations, while higher intake of red and processed meats and added sugars negatively correlated.

Limitations

  • Self-reported data, small study, not all results statistically significant, correlative design, referral center population.

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