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Life sciences · Journal article
Molecular Oncology · September 7, 2026
Early or partial results. Treat as a signal, not a conclusion.
In 62 patients with locally advanced NSCLC undergoing concurrent chemoradiotherapy, gut microbiota alpha diversity remained stable during treatment, but broad-spectrum antibiotic use significantly reduced diversity, and baseline beta diversity differed modestly between survival groups. These associations are descriptive and exploratory, establishing no causal link or predictive utility; the authors themselves characterize the microbiota composition as a 'preliminary biomarker' requiring validation.
Prospective observational cohort study. 62 patients with locally advanced non-small-cell lung cancer undergoing concurrent chemoradiotherapy.. Intervention: Concurrent chemoradiotherapy (CRT); stratified by broad-spectrum antibiotic exposure during CRT.. Compared with: No control group; within-cohort stratification by antibiotic use and survival outcomes.. n = 62.
Alpha diversity stable from baseline to completion of CRT (all P > 0.60) Patients receiving broad-spectrum antibiotics during CRT had significantly lower alpha diversity than those without antibiotics (P = 0.017) Baseline beta diversity differed modestly but significantly between PFS ≥18 vs <18 months groups (PERMANOVA R² = 0.028, P = 0.045)
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These findings do not support clinical use of baseline microbiota profiling for prognostication in NSCLC-CRT. Broad-spectrum antibiotic use during CRT is associated with microbiota disruption, which warrants prospective validation as a potential modifiable factor. The modest baseline beta-diversity signal is exploratory and requires replication in independent cohorts before consideration as a biomarker.
Observational microbiota profiling study in a single cohort showing modest associations with survival outcomes, lacking a control group and powered only to detect compositional differences, not clinical prediction.
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Quoted from the source exactly as published.
These findings do not support clinical use of baseline microbiota profiling for prognostication in NSCLC-CRT. Broad-spectrum antibiotic use during CRT is associated with microbiota disruption, which warrants prospective validation as a potential modifiable factor. The modest baseline beta-diversity signal is exploratory and requires replication in independent cohorts before consideration as a biomarker.
Graded across the dimensions that decide whether you should act, each from what the source actually supports. There is no single score, and where a dimension was not assessed it says so.
Growing evidence suggests that gut microbial features may predict—and potentially modulate—responses to cancer therapy, particularly immunotherapy. However, the impact of concurrent chemoradiotherapy (CRT) on the gut microbiota remains less well‐understood. This knowledge gap is especially relevant in locally advanced non‐small‐cell lung cancer (NSCLC), where CRT typically precedes immunotherapy. We therefore investigated whether CRT alters gut microbial composition and whether such changes are associated with survival outcomes. Fecal samples were collected at three time points: prior to CRT (baseline), at completion of CRT, and immediately before initiation of consolidation immunotherapy, from 62 patients with locally advanced NSCLC. Microbiota profiling was performed using a qPCR‐based panel (PMP™) targeting 108 prevalent microbial taxa. Within‐sample (alpha) and between‐sample (beta) bacterial diversity were assessed across time points and clinical subgroups defined by antibiotic exposure and survival outcomes. Alpha diversity remained stable from baseline to completion of CRT (all P > 0.60). Patients who received broad‐spectrum antibiotics during CRT had significantly lower alpha diversity compared with those who did not receive antibiotics ( P = 0.017), reflecting a transient between‐group difference. Beta diversity differed modestly but significantly at baseline between survival groups (progression‐free survival ≥ 18 vs < 18 months; PERMANOVA R 2 = 0.028, P = 0.045). The gut microbiota appears largely stable during CRT for locally advanced NSCLC but is susceptible to disruption by antibiotic use. Baseline beta diversity differences between survival groups may signal a potential role for gut microbial composition as a future preliminary biomarker and warrant further investigation.
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