Abstract 6673: Tumor microbial burden is regulated by mast cells and determines immunotherapy responses

Abstract Immune checkpoint inhibitors (ICI) have notably improved overall survival rates across various cancers, particularly in cases of mismatch repair deficient cancer (MMRd). However, numerous factors influence patient response following ICI treatment. Beyond genetic factors, mutations, and levels of immune cell infiltration, several studies highlight the correlation between the gut microbiome and treatment response rates. Furthermore, specific bacterial compositions have been observed to shift during therapeutic interventions. Notably, studies have demonstrated that patients who used antibiotics before and during ICI treatment exhibited lower progression-free survival and overall survival, serving as evidence for this association. Our previous investigations elucidated the impact of distinct tumor microbial burdens on modulating immune activation. Consequently, our hypothesis posits the substantive involvement of the interplay between tumor microbial burden and the immune system response to ICI treatment. We evaluated the presence of intra-tumoral microbes within Colorectal cancers (CRC) by examining TCGA data. Patients with elevated microbial levels demonstrated heightened immune activity and better survival rates. Using cybersport analysis, we validated increased mast cell infiltration in CRC patients with abundant microbes. Quantification involved assessing bacterial burden through 16s rRNA via FISH staining and mast cell counts using tryptase via IHC staining. Reducing bacterial load in MC38 cancer model, achieved by locally administering antibiotics, led to a diminished immune response when PD-1 was introduced to these mice. Cross-referencing TCGA data, we identified upregulated genes in CRC patients with high microbial burden and downregulated genes in mice receiving local antibiotics after MC38 cell implantation. The common genes were associated with immune responses, suggesting a strong correlation between bacterial burden and immune activity in CRCs. In conclusion, the high burden of bacteria in CRC improves immune response to ICI and increases the infiltration of mast cells, which all contribute to better survival rates. Citation Format: Hajar Rajaei, Jeong-Hoon Jang, Haoyue Liu, Erika Y. Faraoni, Olivia Le Roux, Vidhi Chandra, Virginia Tahan, Le Li, Erick Riquelme, James Robert White, Luis A. Diaz Jr. , Florencia McAllister. Tumor microbial burden is regulated by mast cells and determines immunotherapy responses abstract. In: Proceedings of the American Association for Cancer Research Annual Meeting 2024; Part 1 (Regular Abstracts) ; 2024 Apr 5-10; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2024;84 (6Suppl): Abstract nr 6673.