The Diversity of Vaginal Microbiota Predicts Neoadjuvant Chemotherapy Responsiveness in Locally Advanced Cervical Cancer

The vaginal microbiota is closely related to HPV infection and cervical cancer, but its relationship with platinum-based chemotherapy responsiveness is unknown. The study aimed to investigate the vaginal microbiota diversity of women with locally advanced cervical cancer and compare the differences between responders and nonresponders. We characterized the 16S rRNA gene sequencing of vaginal microbiome of 35 vaginal samples, including 26 cervical cancer patients before treatment and nine benign controls. Compared with the benign controls, alpha diversity was significantly increased in cervical cancer patients (p<0.05) with more unconventionality bacterial colonization. Beta diversity also significantly differed between cervical cancer patients and controls (p<0.01). Within the cervical cancer patients before neoadjuvant chemotherapy, alpha diversity in vaginal samples was significantly higher in the nonresponders versus the responders (p<0.001), and the Ace index and Chao index were negatively correlated with mass reduction (p<0.001). Moreover, the Bacteroide genus enriched in the nonresponders of neoadjuvant chemotherapy had a ROC-plot AUC value reaching to 0.84. The study suggests the vaginal microbiota in locally advanced cervical cancer patients is associated with platinum-based chemotherapy responsiveness. Alpha diversity and Bacteroide abundance have the potential of identifying platinum-resistant patients at an early time. These findings provide a basis for further research on the relationship between vaginal microbiome and chemotherapy effect in cervical cancer.