Gut microbiome influences efficacy of PD-1-based immunotherapy against epithelial tumors

  • Science. 2018 Jan 5;359(6371):91-97. doi: 10.1126/science.aan3706.
Bertrand Routy  1  2  3 ,  Emmanuelle Le Chatelier  4 ,  Lisa Derosa  1  2  3 ,  Connie P M Duong  1  2  5 ,  Maryam Tidjani Alou  1  2  3 ,  Romain Daillère  1  2  3 ,  Aurélie Fluckiger  1  2  5 ,  Meriem Messaoudene  1  2 ,  Conrad Rauber  1  2  3 ,  Maria P Roberti  1  2  5 ,  Marine Fidelle  1  3  5 ,  Caroline Flament  1  2  5 ,  Vichnou Poirier-Colame  1  2  5 ,  Paule Opolon  6 ,  Christophe Klein  7 ,  Kristina Iribarren  8  9  10  11  12 ,  Laura Mondragón  8  9  10  11  12 ,  Nicolas Jacquelot  1  2  3 ,  Bo Qu  1  2  3 ,  Gladys Ferrere  1  2  3 ,  Céline Clémenson  1  13 ,  Laura Mezquita  1  14 ,  Jordi Remon Masip  1  14 ,  Charles Naltet  15 ,  Solenn Brosseau  15 ,  Coureche Kaderbhai  16 ,  Corentin Richard  16 ,  Hira Rizvi  17 ,  Florence Levenez  4 ,  Nathalie Galleron  4 ,  Benoit Quinquis  4 ,  Nicolas Pons  4 ,  Bernhard Ryffel  18 ,  Véronique Minard-Colin  1  19 ,  Patrick Gonin  1  20 ,  Jean-Charles Soria  1  14 ,  Eric Deutsch  1  13 ,  Yohann Loriot  1  3  14 ,  François Ghiringhelli  16 ,  Gérard Zalcman  15 ,  François Goldwasser  9  21  22 ,  Bernard Escudier  1  14  23 ,  Matthew D Hellmann  24  25 ,  Alexander Eggermont  1  2  14 ,  Didier Raoult  26 ,  Laurence Albiges  1  3  14 ,  Guido Kroemer  27  9  10  11  12  28  29 ,  Laurence Zitvogel  30  2  3  5
Affiliations
  • 1. Gustave Roussy Cancer Campus (GRCC), Villejuif, France.
  • 2. Institut National de la Santé et de la Recherche Medicale (INSERM) U1015 and Equipe Labellisée-Ligue Nationale contre le Cancer, Villejuif, France.
  • 3. Univ. Paris-Sud, Université Paris-Saclay, Gustave Roussy, Villejuif, France.
  • 4. MGP MetaGénoPolis, INRA, Université Paris-Saclay, Jouy-en-Josas, France.
  • 5. Center of Clinical Investigations in Biotherapies of Cancer (CICBT) 1428, Villejuif, France.
  • 6. Gustave Roussy, Laboratoire de Pathologie Expérimentale, 94800 Villejuif, France.
  • 7. Centre de Recherche des Cordeliers, INSERM, Université Paris Descartes, Sorbonne Paris Cité, UMRS 1138, Université Pierre et Marie Curie Université Paris 06, Sorbonne Universités, Paris, France.
  • 8. Metabolomics and Cell Biology Platforms, GRCC, Villejuif, France.
  • 9. Paris Descartes University, Sorbonne Paris Cité, Paris, France.
  • 10. Equipe 11 Labellisée-Ligue Nationale contre le Cancer, Centre de Recherche des Cordeliers, Paris, France.
  • 11. INSERM U1138, Paris, France.
  • 12. Université Pierre et Marie Curie, Paris, France.
  • 13. Department of Radiation Oncology, INSERM U1030, and Molecular Radiotherapy, Gustave Roussy, Université Paris-Saclay, F-94805 Villejuif, France.
  • 14. Department of Medical Oncology, Gustave Roussy, Villejuif, France.
  • 15. Thoracic Oncology Department-CIC1425/CLIP2 Paris-Nord, Hospital Bichat-Claude Bernard, AP-HP, Université Paris-Diderot, Paris, France.
  • 16. Department of Medical Oncology, Center GF Leclerc, Dijon, France.
  • 17. Druckenmiller Center for Lung Cancer Research, Memorial Sloan Kettering Cancer Center, New York, NY, USA.
  • 18. Molecular Immunology and Embryology, UMR 7355, CNRS, University of Orleans, Orléans, France.
  • 19. Department of Pediatric Oncology, GRCC, Villejuif, France.
  • 20. Preclinical Research Platform, GRCC, Villejuif, France.
  • 21. Department of Medical Oncology, Cochin Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France.
  • 22. Immunomodulatory Therapies Multidisciplinary Study Group (CERTIM), Paris, France.
  • 23. INSERM U981, GRCC, Villejuif, France.
  • 24. Department of Medicine, Thoracic Oncology Service, Memorial Sloan Kettering Cancer Center, New York, NY, USA.
  • 25. Department of Medicine, Weill Cornell Medical College, New York, NY, USA.
  • 26. URMITE, Aix Marseille Université, UM63, CNRS 7278, IRD 198, INSERM 1095, IHU-Méditerranée Infection, 13005 Marseille, France.
  • 27. Metabolomics and Cell Biology Platforms, GRCC, Villejuif, France. [email protected] [email protected].
  • 28. Pôle de Biologie, Hôpital Européen Georges Pompidou, Assistance Publique-Hôpitaux de Paris, Paris, France.
  • 29. Department of Women's and Children's Health, Karolinska University Hospital, 17176 Stockholm, Sweden.
  • 30. Gustave Roussy Cancer Campus (GRCC), Villejuif, France. [email protected] [email protected].
Abstract

Immune checkpoint inhibitors (ICIs) targeting the PD-1/PD-L1 axis induce sustained clinical responses in a sizable minority of Cancer patients. We found that primary resistance to ICIs can be attributed to abnormal gut microbiome composition. Antibiotics inhibited the clinical benefit of ICIs in patients with advanced Cancer. Fecal microbiota transplantation (FMT) from Cancer patients who responded to ICIs into germ-free or antibiotic-treated mice ameliorated the antitumor effects of PD-1 blockade, whereas FMT from nonresponding patients failed to do so. Metagenomics of patient stool samples at diagnosis revealed correlations between clinical responses to ICIs and the relative abundance of Akkermansia muciniphila Oral supplementation with A. muciniphila after FMT with nonresponder feces restored the efficacy of PD-1 blockade in an interleukin-12-dependent manner by increasing the recruitment of CCR9+CXCR3+CD4+ T lymphocytes into mouse tumor beds.