The commensal microbiome is associated with anti-PD-1 efficacy in metastatic melanoma patients

Science. 2018 Jan 5;359(6371):104-108. doi: 10.1126/science.aao3290.

Abstract

Anti-PD-1-based immunotherapy has had a major impact on cancer treatment but has only benefited a subset of patients. Among the variables that could contribute to interpatient heterogeneity is differential composition of the patients' microbiome, which has been shown to affect antitumor immunity and immunotherapy efficacy in preclinical mouse models. We analyzed baseline stool samples from metastatic melanoma patients before immunotherapy treatment, through an integration of 16S ribosomal RNA gene sequencing, metagenomic shotgun sequencing, and quantitative polymerase chain reaction for selected bacteria. A significant association was observed between commensal microbial composition and clinical response. Bacterial species more abundant in responders included Bifidobacterium longum, Collinsella aerofaciens, and Enterococcus faecium. Reconstitution of germ-free mice with fecal material from responding patients could lead to improved tumor control, augmented T cell responses, and greater efficacy of anti-PD-L1 therapy. Our results suggest that the commensal microbiome may have a mechanistic impact on antitumor immunity in human cancer patients.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, Non-P.H.S.

MeSH terms

  • Animals
  • Antibodies, Monoclonal / therapeutic use
  • Bifidobacterium longum / classification
  • Bifidobacterium longum / genetics
  • Bifidobacterium longum / immunology
  • Bifidobacterium longum / isolation & purification
  • Enterococcus faecium / classification
  • Enterococcus faecium / genetics
  • Enterococcus faecium / immunology
  • Enterococcus faecium / isolation & purification
  • Feces / microbiology
  • Gastrointestinal Microbiome / genetics
  • Gastrointestinal Microbiome / immunology*
  • Humans
  • Immunotherapy / methods*
  • Melanoma / immunology
  • Melanoma / therapy*
  • Mice
  • Programmed Cell Death 1 Receptor / antagonists & inhibitors*
  • RNA, Ribosomal, 16S / genetics
  • Skin Neoplasms / immunology
  • Skin Neoplasms / therapy*
  • T-Lymphocytes / immunology

Substances

  • Antibodies, Monoclonal
  • Programmed Cell Death 1 Receptor
  • RNA, Ribosomal, 16S