Skip to main content
About the Institute
  • English
  • Français
  • Español
  • Russian
  • Portuguese
  • Polish

Breadcrumb

  1. Home
  2. Gastroenterology
  3. Immune checkpoint inhibitor (ICI) efficacy: the right dose of bacteria
  • Our publications
    • News
    • Microbiota Mag
    • Thematic pages
    • Experts' point of view
    • Thematic folders
    • Overviews - Microbiota Magazine
  • About the Institute
    • About us
    • International Microbiota Observatory
    • Press room
    • Partnerships
  • Congresses
    • Congress calendar
    • Congress reviews
  • Continuing Medical Education
    • Accrediting courses
  • Useful documents
    • How to talk about
    • Infographics
    • IBS Diagnosis Check List
    • Patients Stories

    Join the microbiota community

    • Facebook
    • Twitter
    • LinkedIn
    • YouTube
    • Instagram
    • Bluesky

Lay public section

Find here your dedicated section
Gastroenterology
Gynecology
Pediatrics
General Medicine

Breadcrumb

  1. Home
  2. Gastroenterology
  3. Immune checkpoint inhibitor (ICI) efficacy: the right dose of bacteria
Gastroenterology

Immune checkpoint inhibitor (ICI) efficacy: the right dose of bacteria

Cancer
Gastroenterology Pulmonology Oncology

The gut microbiota is thought to modulate the efficacy of certain anti-cancer drugs such as ICIs. Now it is being studied in the search for bacteria that predict the efficacy of this treatment. However, the results are not quite as expected.

Gastroenterology
Gynecology
Pediatrics
General Medicine
  • Our publications
    • News
    • Microbiota Mag
    • Thematic pages
    • Experts' point of view
    • Thematic folders
    • Overviews - Microbiota Magazine
  • About the Institute
    • About us
    • International Microbiota Observatory
    • Press room
    • Partnerships
  • Congresses
    • Congress calendar
    • Congress reviews
  • Continuing Medical Education
    • Accrediting courses
  • Useful documents
    • How to talk about
    • Infographics
    • IBS Diagnosis Check List
    • Patients Stories

    Join the microbiota community

    • Facebook
    • Twitter
    • LinkedIn
    • YouTube
    • Instagram
    • Bluesky

Lay public section

Find here your dedicated section

Sources

This article is based on scientific information

Sharing is caring

Your colleagues might be interested in this topic. Why not share it?

  • Facebook
  • Twitter
  • LinkedIn
  • Mail
Immune checkpoint inhibitor (ICI) efficacy: the right dose of bacteria

About this article

Created 02 June 2022
Updated 31 August 2023

Immune checkpoint inhibitors (ICI) represent a major breakthrough in the treatment of certain cancers, offering patients an overall survival superior to that expected with chemotherapy, notably in non-small-cell lung cancer (NSCLC) and melanoma. However, some patients do not respond to this treatment as hoped. This difference may be linked in part to the gut microbiota, which is thought to influence the effectiveness of ICIs.

This topic has been the subject of numerous studies, several of which have recently been published in Nature Medicine. The results have improved our understanding in this area, while showing that the mechanisms involved are more complex than initially believed. 

Akk in lung cancer: neither too little nor too much

A first retrospective multicenter study analyzed the microbiota of 338 French patients with advanced NSCLC. The aim was to predict a positive clinical response to anti-PD-1, a type of ICI treatment. More specifically, the investigators sought to confirm previous results obtained in smaller cohorts suggesting that the composition of the gut microbiota, and more specifically the presence of the bacterium Akkermansia muciniphila (Akk), could serve as a biomarker of response and survival at twelve months.

The results? The relative abundance of Akk was clearly associated with clinical benefit (better response rate, better survival). Moreover, the presence of Akk in the gut was an indicator of the richness of the intestinal ecosystem. It was associated with a specific bacterial community linked to health or immunogenic status, represented by Ruminococcacae and Lachnospiraceae, as well as B. adolescentis and I. butyriciproducens. 

However, good survival rates require the right abundance of Akk, neither too little nor too much. Indeed, antibiotic use (20% of cases) favored an overabundance of Akk and of the genus Clostridium, both of which are associated with resistance to ICI and an unfavorable outcome (reduced survival). Thus, it appears that antibiotic-induced dysbiosis reduces beneficial bacteria associated with survival (such as Ruminococcus), in favor of harmful bacteria associated with immunoregulatory or pro-inflammatory pathways (such as Escherichia coli and Clostridium bolteae). Therefore, the relative abundance of Akk represents a potential biomarker (favorable or unfavorable) to refine the stratification of NSCLC patients receiving anti-PD-1 immunotherapy. It may even provide a way of improving responses to treatment via Akk supplementation.

Relationships more complex than expected

A second study based on five previously published cohorts (n = 147) and five new cohorts (n = 165) confirmed that the gut microbiome is associated with response to ICIs and survival in advanced melanoma. However, this association was found to be cohort dependent. In other words, each cohort had its own signature. Consequently, no single species could be regarded as a fully consistent biomarker across studies. Instead, a panel of species, including Bifidobacterium pseudocatenulatum, Roseburia spp., and Akk., may serve as such.

Thus, this second study confirms what the first study suggested: the role of the human gut microbiota in responses to ICI is more complex than previously thought. Neither the presence or absence of any single bacterial species, nor the abundance thereof, as with Akk., is sufficient to define responders or non-responders to ICI treatment.

 This has major implications for future research, namely the need to use larger sample sizes and to take into account the complex interaction of clinical factors (such as antibiotics) with the gut microbiota during treatment.

Recommended by our community

"Gut #Microbiome is a fascinating area of new knowledge we should be aware of!" - Linga Fruit Winery (From Biocodex Microbiota Institute on X)

Sources

Derosa L, Routy B, Thomas AM, et al. Intestinal Akkermansia muciniphila predicts clinical response to PD-1 blockade in patients with advanced non-small-cell lung cancer. Nat Med. 2022 Feb;28(2):315-324.

Lee KA, Thomas AM, Bolte LA, et al. Cross-cohort gut microbiome associations with immune checkpoint inhibitor response in advanced melanoma. Nat Med. 2022 Mar;28(3):535-544.

Tags
Immunity Cancer Immunotherapy Antibiotics Dysbiosis Akkermansia muciniphila Microbiome Flora

    See also

    Actu PRO : Cancer du poumon : le microbiote intestinal signerait un stade précoce Gut microbiota could be an indicator of early-stage lung cancer
    Actu PRO : Le microbiote buccal, facteur de risque de cancer pulmonaire ? Oral microbiota, a risk factor for lung cancer?
    Created 02 June 2022
    Updated 31 August 2023

    About this article

    To know more about this topic.

    Main topic

    Cancer

    Medical practice

    Gastroenterology Pulmonology Oncology

    Content type

    News
    Gastroenterology

    Association between fungal dysbiosis and environment

    The fungal portion of the gut microbiota (or mycobiota) has been much less studied than the bacterial...

    Find out more

    Your IBS Diagnosis Check List

    How many patients suffering from gut disorder do you see per week? How many are diagnosed with Irrita...

    Find out more

    Probiotics: what exactly are we talking about?

    From the Latin pro and Greek bios meaning “for life”, the term “probiotic” was suggested over 60 year...

    Find out more

    How do you choose a probiotic for your patient?

    Faced with a plethora of products on the market, it's not always easy for health professionals to sug...

    Find out more

    The Janus face of Antibiotics: Life Savers and Microbiota Disruptors

    A page turns: with the advent of antibiotics in the...

    Find out more

    Fecal transplantation - ready for prime time?

    Congress review By Pr. Danny De Looze Department of Gastroenterology University Hospital Gent, Belgi...

    Find out more

    Focus on antibiotic associated diarrhea (AAD)

    Find out more

    Dampening gastrointestinal inflammation through nutrition

    by Dr Genelle Healey

    Find out more

    Continue reading

    News
    Actu PRO : Malnutrition : agir sur le microbiote pour améliorer la croissance, un prototype à l’essai
    08.07.2021

    Malnutrition: acting on the microbiota in order to improve growth, a trial prototype

    Read the article
    07.05.2025

    The microbial-metabolic nexus in colon cancer

    Read the article
    07.02.2025

    Your functional dyspepsia diagnosis check list

    Read the article
    17.04.2025

    Sensitivity to the additive E466: the role of the microbiota

    Read the article
    Photo HCPs: Clinical context over quick fix: the fresh consensus on microbiome testing
    11.04.2025

    Clinical context over quick fix: the fresh consensus on microbiome testing

    Read the article
    22.11.2023

    Is vaginal microbiota transfer the new miracle for C-section babies?

    Read the article
    Actu PRO : Alcoolisme : expliquer les troubles sociaux grâce au microbiote
    27.01.2021

    Alcoholism: explaining social disorders thanks to the microbiota

    Read the article
    20.03.2025

    Entacapone and the gut: a hidden impact on parkinson’s care

    Read the article
    • Our publications
      • News
      • Microbiota Mag
      • Thematic pages
      • Experts' point of view
      • Thematic folders
      • Overviews - Microbiota Magazine
    • About the Institute
      • About us
      • International Microbiota Observatory
      • Press room
      • Partnerships
    • Congresses
      • Congress calendar
      • Congress reviews
    • Continuing Medical Education
      • Accrediting courses
    • Useful documents
      • How to talk about
      • Infographics
      • IBS Diagnosis Check List
      • Patients Stories

      Join the microbiota community

      • Facebook
      • Twitter
      • LinkedIn
      • YouTube
      • Instagram
      • Bluesky

    Lay public section

    Find here your dedicated section
    Gastroenterology
    Gynecology
    Pediatrics
    General Medicine
    • English
    • Français
    • Español
    • Russian
    • Portuguese
    • Polish

    Browse the site

    • Our publications
      • News
      • Microbiota Mag
      • Thematic pages
      • Experts' point of view
      • Thematic folders
      • Overviews - Microbiota Magazine
    • About the Institute
      • About us
      • International Microbiota Observatory
      • Press room
      • Partnerships
    • Congresses
      • Congress calendar
      • Congress reviews
    • Continuing Medical Education
      • Accrediting courses
    • Useful documents
      • How to talk about
      • Infographics
      • IBS Diagnosis Check List
      • Patients Stories

      Join the microbiota community

      • Facebook
      • Twitter
      • LinkedIn
      • YouTube
      • Instagram
      • Bluesky

    Lay public section

    Find here your dedicated section

    Discover

    Gastroenterology
    Gynecology
    Pediatrics
    General Medicine

    Join the microbiota community

    • Facebook
    • Twitter
    • LinkedIn
    • YouTube
    • Instagram
    • Bluesky

    Lay public section

    Find here your dedicated section

    Redirection

    You are about to be redirected and leave our website

    • Be redirected
    • Stay on the Biocodex Microbiota Institute's website

    Stay with us !

    Join the Microbiota Community of HCPs and researchers and receive “Microbiota Digest” and "Microbiota Mag" to stay up to date on the latest news about microbiota.

    * Mandatory Fields

    BMI 20-35

    Explore

    14.05.2025

    Towards worldwide redefinition of healthy vaginal microbiota

    Read the article
    07.05.2025

    The microbial-metabolic nexus in colon cancer

    Read the article
    02.05.2025

    A new lens on chlamydia: beyond behavior, into the microbiome

    Read the article

    Stay updated

    Join the Microbiota Community of HCPs and researchers and receive “Microbiota Digest” and "Microbiota Mag" to stay up to date on the latest news about microbiota.

    * Mandatory Fields

    BMI 20-35

    • Our publications
      • News
      • Microbiota Mag
      • Thematic pages
      • Experts' point of view
      • Thematic folders
      • Overviews - Microbiota Magazine
    • About the Institute
      • About us
      • International Microbiota Observatory
      • Press room
      • Partnerships
    • Congresses
      • Congress calendar
      • Congress reviews
    • Continuing Medical Education
      • Accrediting courses
    • Useful documents
      • How to talk about
      • Infographics
      • IBS Diagnosis Check List
      • Patients Stories

      Join the microbiota community

      • Facebook
      • Twitter
      • LinkedIn
      • YouTube
      • Instagram
      • Bluesky

    Lay public section

    Find here your dedicated section

    Discover

    Gastroenterology
    Gynecology
    Pediatrics
    General Medicine

    Lay public section

    Find here your dedicated section

    Join the microbiota community

    • Facebook
    • Twitter
    • LinkedIn
    • YouTube
    • Instagram
    • Bluesky

    © 2025 Biocodex. All rights reserved.

    • Legal notice
    • GTU
    • Data protection policy
    • Sitemap
    • Cookies settings
    • Digital accessibility : partially compliant
    Biocodex logo