Gut microbiota shed new light on the management of immune‐related adverse events. Issue 19 (31st August 2022)

• Record Type: Journal Article
• Authors: Tan, Bei; Liu, Yun‐xin; Tang, Hao; Chen, Dan; Xu, Yan; Chen, Min‐jiang; Li, Yue; Wang, Meng‐zhao; Qian, Jia‐ming
• Is Part Of: Thoracic cancer. Volume 13:Issue 19(2022)
• Page Start: 2681
• Page End: 2691
• Publication Date: 2022-08-31
• Subjects: fecal microbiota transplantation -- immune checkpoint inhibitors -- immune‐related adverse events -- intestinal microbiota -- probiotics; Chest -- Cancer -- Periodicals; Chest -- Cancer -- Treatment -- Periodicals; Chest -- Surgery -- Periodicals; 616.99494005
• DOI: 10.1111/1759-7714.14626
• Languages: English
• ISSNs: 1759-7706

Abstract

Abstract: Immunotherapy has dramatically revolutionized the therapeutic landscape for patients with cancer. Although immune checkpoint inhibitors are now accepted as effective anticancer therapies, they introduce a novel class of toxicity, termed immune‐related adverse events, which can lead to the temporary or permanent discontinuation of immunotherapy and life‐threatening tumor progression. Therefore, the effective prevention and treatment of immune‐related adverse events is a clinical imperative to maximize the utility of immunotherapies. Immune‐related adverse events are related to the intestinal microbiota, baseline gut microbiota composition is an important determinant of immune checkpoint inhibitor‐related colitis, and antibiotics exacerbate these undesirable side‐effects. Supplementation with specific probiotics reduces immune checkpoint inhibitor‐related colitis in mice, and fecal microbiota transplantation has now been shown to effectively treat refractory immune checkpoint inhibitor‐related colitis in the clinic. Hence, modifying the microbiota holds great promise for preventing and treating immune‐related adverse events. Microbiomes and their metabolites play important roles in the potential underlying mechanisms through interactions with both innate and adaptive immune cells. Here we review the gut microbiota and immune regulation; the changes occurring in the microbiota during immune checkpoint inhibitor therapy; the relationship between the microbiota and immune‐related adverse events, antibiotics, probiotics/prebiotics, and fecal microbiota transplantation in immune checkpoint inhibitor‐related colitis; and the protective mechanisms mediated by the microbiome and metabolites in immune‐related adverse events. Abstract : (A) Whether the intestinal microbiota changes after ICI therapy is still uncertain. (B) The baseline gut microbiota composition is an important determinant of ICIs‐related colitis. (C) After the onset of ICIs‐related colitis, the antibiotic application is a harmful factor, particularly those with anaerobic activity. The supplementation of specific probiotics e.g., Bifidobacterium and Lactobacillus could reduce ICIs‐related colitis in mice. FMT could effectively treat refractory ICIs‐related colitis in clinical cases.