Postbiotics Improve ICI-Related Effects in Patients With NSCLC

Inanimate microorganisms or associated components that may provide health benefits are commonly called postbiotics. Other names include nonviable probiotics, paraprobiotics, ghostbiotics, or heat-inactivated probiotics. The application of postbiotics to regulate the gut microbiome is an emerging area of interest.

Researchers in a study noted a previous study suggested JK5G postbiotics may slow colorectal cancer progression and regulate the tumor microenvironment. The study’s authors explored the effects of JK5G postbiotics on immune-related adverse events (AEs) in patients with non-small cell lung cancer (NSCLC) who were treated with immune checkpoint inhibitors (ICIs).

After analysis of 60 patients, the investigators concluded JK5G postbiotics may be able to attenuate immune-related AEs and improve the quality of life (QOL) and nutrition profile of patients with advanced NSCLC on ICI therapy. The findings were presented in Frontiers in Oncology.

JK5G Postbiotics Reduce AEs in NSCLC

The randomized, double-blind, controlled trial enrolled 60 treatment-naive patients with nonsquamous or squamous stage IIIb-IV NSCLC without EGFR, ROS1, or ALK alterations. Patients were assigned to 3-week cycles of programmed cell death 1 (PD-1) inhibitor with chemotherapy plus either JK5G postbiotics or placebo, repeated for 4 cycles.

The primary end point was objective response rate (ORR), and secondary end points included QOL, AEs, gut microbiota composition, inflammatory cytokines, and lymphocyte subsets.

According to the report, the placebo group had an ORR of 36.67% (n=11), while the JK5G postbiotic group had an ORR of 50.0% (n=13) in patients with advanced NSCLC on ICI therapy (P=.297).

Compared with the control group, researchers found patients in the JK5G group had advantages in QOL, nutrition, and depressive symptoms (P<.05), as well as lower rates for the following:

• Anemia (63.33% vs 13.33%; P<.001)
• Decreased lymphocyte count (20% vs 0%; P=.01)
• Decreased appetite (53.33% vs 16.67%; P=.003)
• Nausea (33.33% vs 6.67%; P=.01)
• Asthenia (30.0% vs 6.67%; P=.017)

JK5G postbiotics appeared to increase Faecalibacterium, Ruminococcaceae, and fecal butyrate and diminish Escherichia-Shigella concentrations, according to the study.

Authors noted JK5G postbiotics decreased levels of tumor necrosis factor-alpha, interleukin-2, and C-reactive protein (P<.05). Analysis of peripheral blood from JK5G patients also identified increased CD3-positive and CD4-positive T cell counts and CD4:CD8 ratios (P<.05).

Classifying patients by gut microbiota composition revealed clusters of Blautia and Escherichia-Shigella enterotypes, and the authors suggested, “JK5G postbiotics intervention might be related to enterotype modulations.”

“In summary,” the report ended, “supplementation with JK5G postbiotics might attenuate the incidence rate of [immune-related] AEs and enhance the quality of life and nutritional status in advanced NSCLC patients who received ICIs.”

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