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. 2021 Jan;23(1):31-41.
doi: 10.1177/1099800420942830. Epub 2020 Jul 23.

Changes in Gut Microbiome Associated With Co-Occurring Symptoms Development During Chemo-Radiation for Rectal Cancer: A Proof of Concept Study

Velda J González-Mercado  1   2 , Wendy A Henderson  3 , Anujit Sarkar  4 , Jean Lim  5 , Leorey N Saligan  6 , Lawrence Berk  7 , Larry Dishaw  8 , Susan McMillan  2 , Maureen Groer  2 , Farrah Sepehri  2 , Gail D'Eramo Melkus  1
Affiliations

Changes in Gut Microbiome Associated With Co-Occurring Symptoms Development During Chemo-Radiation for Rectal Cancer: A Proof of Concept Study

Velda J González-Mercado et al. Biol Res Nurs. 2021 Jan.

Abstract

Purpose: To examine a) whether there are significant differences in the severity of symptoms of fatigue, sleep disturbance, or depression between patients with rectal cancer who develop co-occurring symptoms and those with no symptoms before and at the end of chemotherapy and radiation therapy (CRT); b) differences in gut microbial diversity between those with co-occurring symptoms and those with no symptoms; and c) whether before-treatment diversity measurements and taxa abundances can predict co-occurrence of symptoms.

Methods: Stool samples and symptom ratings were collected from 31 patients with rectal cancer prior to and at the end of (24-28 treatments) CRT. Descriptive statistics were computed and the Mann-Whitney U test was performed for symptoms. Gut microbiome data were analyzed using R's vegan package software.

Results: Participants with co-occurring symptoms reported greater severity of fatigue at the end of CRT than those with no symptoms. Bacteroides and Blautia2 abundances differed between participants with co-occurring symptoms and those with no symptoms. Our random forest classification (unsupervised learning algorithm) predicted participants who developed co-occurring symptoms with 74% accuracy, using specific phylum, family, and genera abundances as predictors.

Conclusion: Our preliminary results point to an association between the gut microbiota and co-occurring symptoms in rectal cancer patients and serves as a first step in potential identification of a microbiota-based classifier.

Keywords: chemotherapy and radiation therapy; co-occurrence of symptoms; gut microbiome; rectal cancer.

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Conflict of interest statement

Declaration of Conflicting Interests: The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Figures

Figure 1.
Figure 1.
Taxa that Best Characterize Each Biological Class (those with co-occurring symptoms vs. those with no symptoms) at before (A) and at the end (B) of Chemotherapy and Radiation therapy (CRT) based on linear Discriminant Analysis (LDA) for effect size. Participants with co-Occurring Symptoms had Significant Enrichment for the Genera of Bacteroides at before and Blautia2 at the end of CRT. The 2 ASVs (ASV_99 and ASV_188) both belonged to the genus Blautia, but their Species Level Resolution could not be Obtained. Therefore, they have been coded as Blautia1 and Blautia2.
Figure 2.
Figure 2.
Before Treatment Variable Importance Based on Random Forest Classification of co-Occurring Symptoms Developed by the end of Chemotherapy and Radiation Therapy (CRT).
See this image and copyright information in PMC

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