Prognostic Impact of Probiotic Supplementation on the Outcomes in Patients with Advanced Non-Small Cell Lung Cancer Treated with First-Line Atezolizumab: Pooled Analyses of Five Randomized Control Trials

The lifetime risk of an individual developing lung cancer is approximately 1 in 15 to 17, making lung cancer a leading cause of cancer-related deaths. Non-small cell lung cancer (NSCLC) is the most prevalent type, accounting for 85% of all lung cancer cases. Despite advancements in immunotherapy, which is a type of cancer treatment using the patient’s own immune system to fight cancer cells, particularly with immune checkpoint inhibitors that assist the body in recognizing and attacking cancer cells, treatment outcomes for NSCLC remain suboptimal. Therefore, there is a pressing need to explore novel approaches that can enhance the efficacy of immunotherapy and improve patient outcomes.

Gut microbiota or microbiome is the system of microorganisms in a person's gastrointestinal system. This includes many bacteria, fungi, viruses, and other organisms. The composition of gut microbiota has been linked to the response to immunotherapy. Dysbiosis, a condition characterized by an imbalance between the good and bad bacteria in our intestines, and other disruptions in the gut microbiome have been associated with reduced response rates to immunotherapy in various cancers, including NSCLC.
Probiotics are live bacteria and yeasts promoted as having various health benefits. They're usually added to yoghurts or taken as food supplements, and are often described as "good" or "friendly" bacteria. Probiotics, which promote gut health, may have a positive influence on the tumor immune microenvironment and enhance the response to immunotherapy. However, solid evidence from prospective clinical trials is lacking, and the clinical significance of probiotics in patients with advanced NSCLC receiving
first-line cancer immunotherapy is poorly understood.

The objective of this study is to investigate the prognostic impact of probiotic supplementation on the outcomes in patients with advanced NSCLC treated with first-line atezolizumab (one of the immune checkpoint inhibitors that stop tumors from evading white blood cells and stimulate an immune response against the tumor cells). Probiotic supplementation means taking products like BIOFERMIN, LAC-B and MIYA-BM, which contain good bacteria such as Bifidobacterium and Clostridium bacterium that keep the digestive system healthy.