Rapid Fire Presentation Cancer Survivorship Conference 2023

Burkholderiaceae abundance in the gut microbiota is associated with cognitive impairment and gastrointestinal symptoms in women treated with chemotherapy for breast cancer: pilot results of the PREDiCT Study (#23)

Courtney Subramaniam 1 2 , Rohit Joshi 3 4 , Beverley Fosh 5 , Bogda Koczwara 6 , Marc Gladman 1 , Joanne Bowen 1 , Hannah Rose Wardill 1
  1. The University of Adelaide, Adelaide, SA, Australia
  2. South Australian Health and Medical Research Institute (SAHMRI), Adelaide, SA, Australia
  3. Medical Oncology, Calvary Central Districts Hospital, Adelaide, SA, Australia
  4. Medical Oncology, Lyell McEwin Hospital, Adelaide, SA, Australia
  5. Outpatients Breast Clinic, Modbury Hospital, Adelaide, SA, Australia
  6. Medical Oncology, Flinders Medical Centre, Adelaide, SA, Australia

Chemotherapy-induced cognitive impairment (CICI) is a poorly defined complication of chemotherapy treatment that has been recognised as a priority concern by cancer survivors, given the symptom burden and lack of therapeutic options. A growing body of anecdotal evidence suggests that the gastrointestinal microbiota may play a role in CICI development, through its influence over neuropathological events via the microbiota-gut-brain axis. However, the relationship between microbiota composition and CICI development has not been explored in a longitudinal study. Therefore, we aimed to longitudinally characterise the individual, dynamic shifts in gastrointestinal microbiota composition during chemotherapy treatment and identify pre- and post-treatment microbial signatures associated with the neurocognitive signatures induced by chemotherapy. Twenty-two women, newly diagnosed with breast cancer, each provided N=4 stool samples across the first two cycles of chemotherapy treatment for microbiota analysis using 16S. Time-matched data on neurocognitive and gastrointestinal symptoms were also provided using the Functional Assessment of Cancer Therapy – Cognitive Function version 3 (FACT-Cog) questionnaire and the Functional Assessment of Chronic Illness Therapy – Diarrhoea Subscale (FACIT-DS) respectively. The relative abundance of Burkholderiaceae was found to be significantly increased in individuals with cognitive impairment (p<0.0001), and strongly associated with both FACT-Cog (p<0.0001) and FACIT-DS (p=0.0017) total scores. This established that as Burkholderiaceae relative abundance increased, cognitive impairment and diarrhoea burden worsened. Akkermansiaceae was the taxon most significantly enriched in participants with no cognitive impairment (p=0.0308) but, this did not significantly correlate with FACT-Cog or FACIT-DS total scores. Although this study did not identify predictive, baseline microbial signatures of CICI, there was evidence of a triadic relationship present within the microbiota-gut-brain axis in women with breast cancer undergoing chemotherapy. Consequently, the role of microbial-targeted preventative or therapeutic measures for CICI warrants further investigation.