A Natural Polyphenol Exerts Antitumor Activity and Circumvents Anti–PD-1 Resistance through Effects on the Gut Microbiota

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Messaoudene, Meriem | Pidgeon, Reilly | Richard, Corentin | Ponce, Mayra | Diop, Khoudia | Benlaifaoui, Myriam | Nolin-Lapalme, Alexis | Cauchois, Florent | Malo, Julie | Belkaid, Wiam | Isnard, Stephane | Fradet, Yves | Dridi, Lharbi | Velin, Dominique | Oster, Paul | Raoult, Didier | Ghiringhelli, François | Boidot, Romain | Chevrier, Sandy | Kysela, David | Brun, Yves | Falcone, Emilia Liana | Pilon, Geneviève | Oñate, Florian Plaza | Gitton-Quent, Oscar | Le Chatelier, Emmanuelle | Durand, Sylvere | Kroemer, Guido | Elkrief, Arielle | Marette, André | Castagner, Bastien | Routy, Bertrand

Edité par CCSD ; American Association for Cancer Research -

International audience. Abstract Several approaches to manipulate the gut microbiome for improving the activity of cancer immune-checkpoint inhibitors (ICI) are currently under evaluation. Here, we show that oral supplementation with the polyphenol-rich berry camu-camu (CC; Myrciaria dubia) in mice shifted gut microbial composition, which translated into antitumor activity and a stronger anti–PD-1 response. We identified castalagin, an ellagitannin, as the active compound in CC. Oral administration of castalagin enriched for bacteria associated with efficient immunotherapeutic responses (Ruminococcaceae and Alistipes) and improved the CD8+/FOXP3+CD4+ ratio within the tumor microenvironment. Moreover, castalagin induced metabolic changes, resulting in an increase in taurine-conjugated bile acids. Oral supplementation of castalagin following fecal microbiota transplantation from ICI-refractory patients into mice supported anti–PD-1 activity. Finally, we found that castalagin binds to Ruminococcus bromii and promoted an anticancer response. Altogether, our results identify castalagin as a polyphenol that acts as a prebiotic to circumvent anti–PD-1 resistance. Significance: The polyphenol castalagin isolated from a berry has an antitumor effect through direct interactions with commensal bacteria, thus reprogramming the tumor microenvironment. In addition, in preclinical ICI-resistant models, castalagin reestablishes the efficacy of anti–PD-1. Together, these results provide a strong biological rationale to test castalagin as part of a clinical trial. This article is highlighted in the In This Issue feature, p. 873

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