PROJECT SUMMARY/ABSTRACT
Microbes live in primary tumors across organ systems and in tumor metastases, making the microbes an intrinsic
and essential component of the tumor microenvironment, yet what types of microbes reside in tumors and how
they contribute to the tumor microenvironment, T cell function, and immunotherapy response are unknown. We
modeled estimated tumor bacterial burden against the known objective response rate to immunotherapy across
tumor types and observed a remarkable correlation between high bacterial burden and high response rates to
immunotherapy, suggesting that the community of microbes in the tumor, or tumor microbiota, plays a pivotal
role in influencing the response rate to immunotherapy. Our preliminary data supports this hypothesis, showing
that increased numbers of microbial species in tumor microbiota correlate with increased numbers of immune
cells in the tumor and response to immunotherapy in head and neck squamous cell carcinoma patients. However,
the microbial composition of and the mechanisms by which intratumoral microbiota influence these clinical
outcomes are currently unknown. While intratumoral microbiota communities remain a mystery, recent studies
have implicated the influence of intestinal microbiota on immunotherapy outcome, whereby responding patients
harbor specific intestinal microbial communities associated with enhanced systemic immunity and intratumoral
immune infiltration. Interestingly, microbes from the gastrointestinal tract traffic to distant tumors, thus potentially
seeding the intratumoral microbiota. For example, Bifidobacteria, a bacterial genera associated with
immunotherapy efficacy, is known to translocate from the intestine to distant tumors. Thus, intestinal microbiota
may influence immunotherapy response through microbial dissemination to tumors. Herein we propose to test
whether intestinal microbes associated with immunotherapy efficacy promote bacterial or bacterial
product translocation from the intestine to the lymph nodes and/or tumor. Further, we aim to uncover
unique mechanisms by which intratumoral microbiota, through either direct immune cell interaction or
the modulation of tumor microenvironment, influence immunotherapy efficacy. This knowledge may
uncover unique opportunities to develop new therapeutic options for patients with cancer, either before standard
of care treatments or synergistically through augmentation of current immunotherapy regimens. Toward this end,
we hope to leverage the knowledge we gain from this proposal with respect to intratumoral microbiota to develop
bacterial drugs in the localized, intratumoral setting thus minimizing systemic effects of potentially detrimental
disruptions to intestinal microbial communities. Thus, our mechanistic approach has the potential to lead to
innovative microbiome-based treatments that may increase the number of patients responding to
immunotherapy.