Impact of the Gut Microbiome on Response and Toxicity to Chemotherapy in Advanced Esophageal Cancer

Objective: To identify the gut bacteria associated with chemotherapeutic outcomes, t characterized the gut microbiota in patients with esophageal squamous cell carcinoma (ESCC) in this prospective study.

Design: Thirty-one patients with ESCC were enrolled. Chemotherapy was performed with paclitaxel and cisplatin (TP). Fecal samples were collected before and after treatment and analyzed using 16S rRNA sequencing.

Results: The species with differences in baseline abundance between partial response (PR) and non-PR groups was identified as ( = 0.043). The baseline abundance of was higher in the responder (R, PR + stable disease (SD)) group ( = 0.045) than in the non-responder (NR). The abundance of was identified as a predictor for distinguishing patients with PR from those without PR (sensitivity, 83.3 %; specificity, 69.6 %). The abundance of was positively associated with the response to PR + SD (R) in predicting responders in the receiver operating characteristic (ROC) curve analysis (area under the ROC curve = 0.865,  = 0.041). The abundance of and was a predictor of grade (G) 3-4 chemotherapy toxicities. The sensitivity and specificity of the established multi-analyte microbial predictive model demonstrated a better predictive ability than a single parameter ( or ).

Conclusion: The abundance of gut microbiota and are associated with the efficacy of TP chemotherapy in patients with ESCC. The abundance of and may related to the toxicity of TP chemotherapy.