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Abstract

Abstract Title

Gut Microbiota Affects the Efficacy of Neoadjuvant Chemotherapy Combined with Immunotherapy in Muscle-Invasive Bladder Cancer

Presentation Type

Podium Abstract

Manuscript Type

Clinical Research

Abstract Category *

Oncology: Bladder and UTUC

Author's Information

Number of Authors (including submitting/presenting author) *

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Co-author 1

Pu Lei 852689026@qq.com Yulin Hospital of the First Affiliated Hospital of Xi’an Jiaotong University Department of Urology Yulin China *

Co-author 2

Tianyu Qi qty3325303051@stu.xjtu.edu.cn First Affiliated Hospital of Xi'an Jiaotong University Department of Urology Xi'an China -

Co-author 3

Tao Li Li_Tao_9786@163.com First Affiliated Hospital of Xi'an Jiaotong University Department of Urology Xi'an China -

Co-author 4

Guoqiang Gao gaoguoqiang@stu.xjtu.edu.cn First Affiliated Hospital of Xi'an Jiaotong University Department of Urology Xi'an China -

Co-author 5

Feng Zhu zhufeng1982@xjtu.edu.cn First Affiliated Hospital of Xi'an Jiaotong University Department of Urology Xi'an China -

Co-author 6

Kaijie Wu kaijie_wu@163.com First Affiliated Hospital of Xi'an Jiaotong University Department of Urology Xi'an China - Yulin Hospital of the First Affiliated Hospital of Xi’an Jiaotong University Department of Urology Yulin China

Co-author 7

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Co-author 10

Co-author 11

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Abstract Content

Introduction

For patients with muscle-invasive bladder cancer (MIBC), the main treatment methods are radical cystectomy, however, approximately 50% of patients experience metastasis following surgical intervention. Currently, neoadjuvant chemotherapy with cisplatin is the standard recommendation as per clinical guidelines, while immunotherapy based on immune checkpoint inhibitors (ICIs) has emerged as a promising alternative. Recent studies suggest that primary resistance to ICIs may be associated with dysbiosis of the gut microbiota. This study aims to investigate the differences in gut microbiota among MIBC patients exhibiting varied responses to neoadjuvant chemotherapy combined with immunotherapy (chemo-immunotherapy), especially to elucidate the effects of gut microbiota on treatment efficacy and identify specific bacterial taxa as potential biomarkers for clinical decision-making.

Materials and Methods

Patients with pathologically confirmed MIBC (T2-4aN0M0) from the First Affiliated Hospital of Xi'an Jiaotong University were included. Based on postoperative pathological response, patients were stratified into non-response (NR, ≥pT2) and response (R,

Results

A total of 38 patients undergoing neoadjuvant chemo-immunotherapy were enrolled in this study, comprising 22 patients (57.89%) in the R group and 16 patients (42.11%) in the NR group. Metagenomic sequencing revealed a statistically significant difference in alpha diversity assessed by the Shannon index (p=0.0086). Principal Coordinates Analysis (PCoA) based on Bray-Curtis distance demonstrated significant differences in beta diversity (p=0.001). Furthermore, the microbial composition analysis identified 255 species with statistically significant differences at the species level between the groups. Notably, Bifidobacterium longum was significantly elevated in the R group (p < 0.001). Linear discriminant analysis coupled with effect size (LEfSe) confirmed Bifidobacterium longum as a potential biomarker to distinguish the efficacy of neoadjuvant chemo-immunotherapy.

Conclusions

The efficacy of neoadjuvant chemo-immunotherapy in MIBC patients appears to be modulated by the abundance of specific gut microbiota, and Bifidobacterium longum is identified as a potential biomarker to differentiate treatment responses.

Keywords

Muscle-Invasive Bladder Cancer, Gut Microbiota, Neoadjuvant Chemotherapy, Immunotherapy

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