Gut microbiome linked to cancer CAR T therapy response
For patients with B cell lymphomas, the gut microbiome may modulate the efficacy of CAR-T immunotherapy, research has found.
The largest prospective study of its kind has shown that obtaining individualised gut microbiome data prior to CAR T therapy could accurately predict treatment responsiveness. This was shown to only be possible if patients were not pre-treated with broad spectrum antibiotics.
The study followed 172 lymphoma patients who had undertaken multiple failed rounds of chemotherapy, from before starting CAR T immunotherapy until two years later.
Data showed that 20 percent of patients receiving a subset of broad-spectrum antibiotics, such as meropenem, piperacillin–tazobactam or cefepime, featured an altered clinical response to subsequent CAR-T therapy. This was compared to patients who received other antibiotics and patients who were not treated with antibiotics prior to therapy.
The reduced response was identified to not be driven by effects of the antibiotics themselves, but due to use of broad-spectrum antibiotics prior to CAR-T therapy. These patients were found to have higher pre-therapy tumour burden and systemic inflammation, compared to non-antibiotics-treated patients.
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