TITLE:
The Predictive Potential of Intestinal Microbiota for the Chemotherapy Efficacy of Patients with Cachexia in Advanced Colorectal Cancer
AUTHORS:
Wei Shi, Xuting Zhu, Jingjing Ruan, Sangui Yi, Jinhua Wang, Lingling Huang
KEYWORDS:
Advanced Colorectal Cancer, Cachexia, Intestinal Microbiota, Chemotherapy Efficacy, Predictive Value
JOURNAL NAME:
Journal of Biosciences and Medicines,
Vol.14 No.5,
May
20,
2026
ABSTRACT: Objective: The study aims to explore the predictive potential of intestinal microbiota characteristics for the chemotherapy efficacy of patients with cachexia in the middle and advanced stages of colorectal cancer. Methods: A total of 96 patients were enrolled. According to the inclusion and exclusion criteria, 40 patients were ultimately included in the study. The blood and fecal samples were collected from patients before chemotherapy and 6 months after treatment for routine blood tests and 16S rRNA-based intestinal microbiota sequencing. At the same time, the nutritional risk screening (NRS 2002) score and body composition analysis indicators were dynamically monitored and recorded. After completing the standardized chemotherapy, a review of abdominal CT was conducted at the 6th month of follow-up. According to the CT results, the patients were divided into three groups using the Response Evaluation Criteria in Solid Tumors (RECIST 1.1 version): 22 cases in the remission group (RG), 8 cases in the stable group (SDG), and 10 cases in the progression group (PDG). Results: Before and after treatment, there were no statistically significant differences in NRS 2002 scores, KPS scores, BMI, grip strength, serum indicators, and body composition index among the groups (P > 0.05). Before treatment, the ACE index, Chao1 index, Shannon index, and Simpson index of intestinal microbiota diversity of the RG group were higher than those of the PDG group (P Faecalibacterium. While those in the SDG group were amino acid metabolism-related genera, such as Acidaminococcus. And those in the PDG group were Lactobacillaceae and Clostridium. After treatment, the dominant bacteria in the RG group were from the family Carnobacteriaceae, whereas those in the SDG group were Desulfovibrio. And those in the PDG group were Streptococcaceae and other pro-inflammatory bacteria. Conclusion: The intestinal microbiota composition of patients with cachexia at baseline could be a potential biomarker for predicting the efficacy of chemotherapy.