Physiologic colonic uptake of 18 F-FDG on PET/CT is associated with clinical response and gut microbiome composition in patients with advanced non-small cell lung cancer treated with immune checkpoint inhibitors

摘要: Immune checkpoint inhibitors (ICI) represent the backbone treatment for advanced non-small cell lung cancer (NSCLC). Emerging data suggest that increased gut microbiome diversity is associated with favorable response to ICI and antibiotic-induced dysbiosis deleterious outcomes. 18F-FDG physiologic colonic uptake on PET/CT increases following antibiotics (ATB) could act as a surrogate marker composition predict prognosis. The aim of this study was determine if prior initiation correlates profiling clinical outcomes in patients NSCLC. Seventy-one NSCLC who underwent were identified. Blinded contouring performed each colon segment stratified according median average SUVmax well low vs. high groups. Response rate, progression-free survival (PFS), overall (OS) compared Gut analyzed 23 using metagenomics sequencing. group had higher proportion non-responders (p = 0.033) significantly shorter PFS (4.1 11.3 months, HR 1.94, 95% CI 1.11–3.41, p = 0.005). High caecum correlated numerically OS (10.8 27.6 months, 1.85, 0.97–3.53, p = 0.058). Metagenomics sequencing revealed distinctive populations group. Patients (p = 0.046) enriched Bifidobacteriaceae, Lachnospiraceae, Bacteroidaceae. Lower better Here, we propose serve potential novel may population.