Gut microbiota signatures are associated with toxicity to combined CTLA-4 and PD-1 blockade Journal Article


Authors: Andrews, M. C.; Duong, C. P. M.; Gopalakrishnan, V.; Iebba, V.; Chen, W. S.; Derosa, L.; Khan, M. A. W.; Cogdill, A. P.; White, M. G.; Wong, M. C.; Ferrere, G.; Fluckiger, A.; Roberti, M. P.; Opolon, P.; Alou, M. T.; Yonekura, S.; Roh, W.; Spencer, C. N.; Curbelo, I. F.; Vence, L.; Reuben, A.; Johnson, S.; Arora, R.; Morad, G.; Lastrapes, M.; Baruch, E. N.; Little, L.; Gumbs, C.; Cooper, Z. A.; Prieto, P. A.; Wani, K.; Lazar, A. J.; Tetzlaff, M. T.; Hudgens, C. W.; Callahan, M. K.; Adamow, M.; Postow, M. A.; Ariyan, C. E.; Gaudreau, P. O.; Nezi, L.; Raoult, D.; Mihalcioiu, C.; Elkrief, A.; Pezo, R. C.; Haydu, L. E.; Simon, J. M.; Tawbi, H. A.; McQuade, J.; Hwu, P.; Hwu, W. J.; Amaria, R. N.; Burton, E. M.; Woodman, S. E.; Watowich, S.; Diab, A.; Patel, S. P.; Glitza, I. C.; Wong, M. K.; Zhao, L.; Zhang, J.; Ajami, N. J.; Petrosino, J.; Jenq, R. R.; Davies, M. A.; Gershenwald, J. E.; Futreal, P. A.; Sharma, P.; Allison, J. P.; Routy, B.; Zitvogel, L.; Wargo, J. A.
Article Title: Gut microbiota signatures are associated with toxicity to combined CTLA-4 and PD-1 blockade
Abstract: Treatment with combined immune checkpoint blockade (CICB) targeting CTLA-4 and PD-1 is associated with clinical benefit across tumor types, but also a high rate of immune-related adverse events. Insights into biomarkers and mechanisms of response and toxicity to CICB are needed. To address this, we profiled the blood, tumor and gut microbiome of 77 patients with advanced melanoma treated with CICB, with a high rate of any ≥grade 3 immune-related adverse events (49%) with parallel studies in pre-clinical models. Tumor-associated immune and genomic biomarkers of response to CICB were similar to those identified for ICB monotherapy, and toxicity from CICB was associated with a more diverse peripheral T-cell repertoire. Profiling of gut microbiota demonstrated a significantly higher abundance of Bacteroides intestinalis in patients with toxicity, with upregulation of mucosal IL-1β in patient samples of colitis and in pre-clinical models. Together, these data offer potential new therapeutic angles for targeting toxicity to CICB. © 2021, The Author(s), under exclusive licence to Springer Nature America, Inc.
Journal Title: Nature Medicine
Volume: 27
Issue: 8
ISSN: 1078-8956
Publisher: Nature Publishing Group  
Date Published: 2021-08-01
Start Page: 1432
End Page: 1441
Language: English
DOI: 10.1038/s41591-021-01406-6
PUBMED: 34239137
PROVIDER: scopus
PMCID: PMC11107795
DOI/URL:
Notes: Article -- Export Date: 1 September 2021 -- Source: Scopus
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  1. Michael Andrew Postow
    361 Postow
  2. Margaret Kathleen Callahan
    197 Callahan
  3. Charlotte Eielson Ariyan
    154 Ariyan
  4. Matthew J Adamow
    24 Adamow