Baseline gut microbiome alpha diversity predicts chemotherapy-induced gastrointestinal symptoms in patients with breast cancer

Lauren D Otto-Dobos; Lindsay D Strehle; Brett R Loman; Melina M Seng; Sagar D Sardesai; Nicole O Williams; Margaret E Gatti-Mays; Daniel G Stover; Preeti K Sudheendra; Robert Wesolowski; Rebecca R Andridge; Michael T Bailey; Leah M Pyter

doi:10.1038/s41523-024-00707-6

Baseline gut microbiome alpha diversity predicts chemotherapy-induced gastrointestinal symptoms in patients with breast cancer

NPJ Breast Cancer. 2024 Nov 15;10(1):99. doi: 10.1038/s41523-024-00707-6.

Authors

Affiliations

¹ Institute for Behavioral Medicine Research, The Ohio State University, Columbus, OH, USA.
² Center for Microbial Pathogenesis and Oral and Gastrointestinal Microbiology Research Affinity Group, The Research Institute at Nationwide Children's Hospital, Columbus, OH, USA.
³ Department of Animal Sciences, University of Illinois, Urbana, IL, USA.
⁴ Division of Medical Oncology, Department of Internal Medicine, The Ohio State University, Columbus, OH, USA.
⁵ Division of Biostatistics, The Ohio State University, Columbus, OH, USA.
⁶ Institute for Behavioral Medicine Research, The Ohio State University, Columbus, OH, USA. [email protected].
⁷ Department of Psychiatry and Behavioral Health, The Ohio State University, Columbus, OH, USA. [email protected].

Abstract

Chemotherapy frequently causes debilitating gastrointestinal symptoms, which are inadequately managed by current treatments. Recent research indicates the gut microbiome plays a role in the pathogenesis of these symptoms. The current study aimed to identify pre-chemotherapy microbiome markers that predict gastrointestinal symptom severity after breast cancer chemotherapy. Fecal samples, blood, and gastrointestinal symptom scores were collected from 59 breast cancer patients before, during, and after chemotherapy. Lower pre-chemotherapy microbiome alpha diversity and abundance of specific microbes (e.g., Faecalibacterium) predicted greater chemotherapy-induced gastrointestinal symptoms. Notably, tumor and diet characteristics were associated with lower pre-chemotherapy alpha diversity. Lower baseline alpha diversity also predicted higher chemotherapy-induced microbiome disruption, which was positively associated with diarrhea symptoms. The results indicate certain cancer patients have lower microbiome diversity before chemotherapy, which is predictive of greater chemotherapy-induced gastrointestinal symptoms and a less resilient microbiome. These patients may be strong candidates for pre-chemotherapy microbiome-directed preventative interventions (e.g., diet change).