A study by Case CCC Trainee Associate Member, Laura Bukavina, MD, MPH, and published in Cancer Research Communications, constitutes the first large-scale, multi-center assessment of gut microbiome (GM) composition, suggesting the potential for a complex microbial signature to predict patients more likely to respond to neoadjuvant chemotherapy (NAC) based on multiple taxa.
NAC is linked with clinical advantages in urothelial carcinoma for patients with muscle-invasive bladder cancer (MIBC). Despite comprehensive research into the influence of tumor mutation expression profiles and clinicopathologic factors on chemotherapy response, the role of the gut microbiome (GM) in bladder cancer chemotherapy response remains poorly understood. In this study, the researchers examined the variance in the GM of patients with bladder cancer compared with healthy adults. It investigated the GM compositional differences between patients who respond to chemotherapy versus those exhibiting residual disease, revealing distinct clustering that effectively separated the bladder cancer and healthy cohorts.
However, no significant differences were observed between chemotherapy responders and nonresponders within community subgroups. Machine learning models based on responder status outperformed clinical variables in predicting complete response (AUC 0.88 vs. AUC 0.50), although no single microbial species emerged as a fully reliable biomarker.