Association Of Gut Microbiota And EGFR-TKIs-Related Skin Rash In Non-small Cell Lung Cancer

Objective:Non-small Cell Lung Cancer(NSCLC)patients who are receiving epidermal growth factor receptor-tyrosine kinase inhibitor(EGFR-TKI)have a high skin rash incidence.We explored the gut bacteriomic profiling in patients with NSCLC receiving EGFR-TKI,and evaluated the relationship between EGFR-TKIs-related skin rash and gut microbiota.Methods:From January 2017 to June 2017,stool samples were collected from NSCLC patients receiving single drug therapy of "geftiinib" or "erlotinib" at week 3.The stool bacteriomic profiling of patients was characterized by 16S rRNA sequencing.Analyze the difference of gut bacteriomic profiling between the skin rash patients and non-skin rash patients.Results:A total of 53 patients,31 patients with rash and 22 patients without rash were collected in this study.Our results revealed that bacterial community structure altered,the proportion of bacteria such as lactobacillus,bacteroides and bifidobacterium decreased obviously.Patients who eventually developed skin rash harbored a significantly higher bacterial alpha diversity,and had a higher abundance of actinomycetes and bifidobacteria.The non-rash patients had a higher abundance of lactobacilli.There was no significant difference in intestinal flora diversity among patients with different rash grades,gefitinib and erlotinib,first-line treatment and non-first-line treatment.Conclusion:1.The intestinal flora-diversity of patients in the rash group was higher than that in the no rash group;2.The composition and structure of intestinal flora of patients in the rash group were different from those in the non-rash group at different classification levels;3.Specific bacterial flora was found in the intestinal tract of patients in the skin rash group and patients in the lung rash group.