Association between intra-tumoral microbiome and clinical benefit (CB) from immunotherapy (IO) in patients with metastatic renal cell carcinoma (mRCC).

Authors

null

Luis A Meza

City of Hope Comprehensive Cancer Center, Duarte, CA

Luis A Meza , Yongwook Choi , Jiaming Zhang , Nazli Dizman , Zeynep Busra Zengin , Hedyeh Ebrahimi , Regina Barragan-Carrillo , Joann Hsu , Neal Shiv Chawla , Alex Chehrazi-Raffle , Abhishek Tripathi , Daniela V. Castro , Benjamin D Mercier , Ameish Govindarajan , Agnes Chan , Nicholas Schork , Sara A. Byron , Sumanta Kumar Pal

Organizations

City of Hope Comprehensive Cancer Center, Duarte, CA, Quantitative Medicine and Systems Biology Division, Translational Genomics Research Institute, Phoenix, AZ, Integrated Cancer Genomics Division, Translational Genomics Research Institute, Phoenix, AZ, Yale University School of Medicine, New Haven, CT, Insituto Nacional de Ciencias Medicas y Nutricion Salvador Zubiran, Belisario Domínguez Secc Xvi, Mexico, Department of Medical Oncology & Experimental Therapeutics, City of Hope Comprehensive Cancer Center, Duarte, CA, City of Hope, Duarte, CA

Research Funding

No funding received
None.

Background: Specific bacteria and microbial diversity in the gut may drive response to IO in patients (pts) with mRCC (Routy et al Science 2018; Salgia et al Eur Urol 2020). Despite the evidence of bacterial proliferation in RCC tumors (Heidler et al Urol Int 2020), the impact of the intra-tumoral microbiome in RCC has been poorly delineated. Here, we explored its association to CB in mRCC pts receiving IO-based regimens. Methods: We identified pts with mRCC and available RNA sequencing (RNA-seq) data from tumor tissue collected prior to start of IO.Intra-tumoral microbiome analysis was performed on formalin-fixed paraffin-embedded samples. Following quality and adapter trimming, RNA-seq reads were mapped to a human genome to filter host reads using the STAR alignment tool. Taxonomic classification was performed using Kraken2 and Bracken. Following removal of common contaminants, the relative abundances among all non-human species were calculated. Microbial diversity was assessed using the Shannon index and statistical analysis performed using a t-test. Relative microbial abundance was compared between tumors from pts with or without CB from 1st line IO treatment using the Kruskal-Wallis test. P-values less than 0.05 were considered significant. Results: A total of 96 pts (71:25, M:F) with mRCC were included in this analysis. Of these, 85 (89%) had clear cell histology and 68 (71%) were IMDC intermediate/poor risk. The median age at the time of tissue sampling was 62.7 yrs old and most of the samples analyzed (57%) were collected from the primary site. IO, alone or in combination, was received as 1st line treatment in 57 pts (59%), with the most common regimen being nivolumab/ipilimumab (47%). CB from 1st line IO was observed in 39 (68%) pts. Tumors from pts achieving CB from 1st line IO had elevated microbial diversity compared to tumors from pts without CB (p=0.01). Tumor samples from these pts also had a significantly higher relative abundance of several bacterial genera compared to tumors from pts without CB. These included Pasteurella, Escherichia, and Cloacibacterium (p<0.05). No significant differences in bacterial diversity were observed between CB and no-CB pts receiving IO as 2nd line or beyond. Conclusions: This is the largest study exploring the association between the intra-tumoral microbiome of mRCC and CB from IO. In line with gut microbiome studies, an increased intra-tumoral Shannon diversity index was also associated with CB to IO in our 1st line cohort, further suggesting that bacterial diversity could be a driver of response. Additionally, several genera associated with CB are particularly relevant. For instance, members of the Pasteurella genus have been implicated in the activation of c-myc, a proto-oncogene that has been shown to induce PD-L1 expression.

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Abstract Details

Meeting

2023 ASCO Annual Meeting

Session Type

Poster Session

Session Title

Genitourinary Cancer—Kidney and Bladder

Track

Genitourinary Cancer—Kidney and Bladder

Sub Track

Kidney Cancer

Citation

J Clin Oncol 41, 2023 (suppl 16; abstr 4561)

DOI

10.1200/JCO.2023.41.16_suppl.4561

Abstract #

4561

Poster Bd #

53

Abstract Disclosures

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