Longitudinal Analysis of Psychoneurological Symptoms and the Gut Microbiome in Patients With Melanoma Receiving Immune Checkpoint Inhibitors.

OBJECTIVES

To characterize the severity of psychoneurological (PN) symptoms in cancer survivors who initiated immune checkpoint inhibitors (ICIs) at baseline and 12 weeks post-treatment and to examine the associations between PN symptoms and gut microbiome patterns.

SAMPLE AND

SETTING

15 patients (n = 9 males and n = 6 females, mean age = 70.9 years) with solid tumors who initiated ICIs were recruited from a cancer center.

METHODS AND VARIABLES: PN symptoms were assessed using self-report questionnaires, and stool samples were analyzed using 16S rRNA sequencing. Alpha and beta diversity indices were calculated, and a least absolute shrinkage and selection operator regression model was fitted to assess associations between each symptom and the log-ratio of the genus abundance.

RESULTS

Average fatigue levels increased during 12 weeks. The microbiome community varied by age, sex, and their interaction. At 12 weeks post-treatment, Oscillibacter (beta = -0.141), Limosilactobacillus (beta = 0.088), and Erysipelotrichaceae (beta = -0.021) were associated with average levels of fatigue, whereas Tannerellaceae (beta = -0.011), Bacteroides (beta = 0.474), and Acidaminococcus (beta = 0.193) were associated with pain severity (all p < 0.05).

IMPLICATIONS FOR NURSING: Given the potential association between the gut microbiome and PN symptoms during ICI treatment, nurses are encouraged to assess dysbiosis risk, screen for treatment-related adverse symptoms, and educate patients about gut health while receiving ICIs.