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The Urinary Microbiome and Anticancer Immunotherapy: The Potentially Hidden Role of Unculturable Microbes

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Abstract

Several urinary disorders, including overactive bladder, urinary incontinence, and interstitial cystitis, are often characterized by negative urine cultures. The application of metagenomics (i.e., 16S rRNA microbial profiling or whole-genome shotgun sequencing) to urine samples has enabled the identification of previously undetected bacteria, contributing to the discovery and characterization of the urinary microbiome. The most frequent species isolated are Lactobacillus (15%), Corynebacterium (14.2%), Streptococcus (11.9%), Actinomyces (6.9%), and Staphylococcus (6.9%). Although several studies are emerging in this context, the role of urinary microbiota in the pathogenesis of infections and in tumor carcinogenesis remains unclear. Furthermore, data on the activity of gut microbiota in modulating sensitivity to immune checkpoint inhibitors in advanced cancer patients suggest that the influence of urinary microbiota on tumor response to anticancer therapy should also be investigated. Moreover, its possible relationship with tumor mutational burden, which is in turn correlated with response to immunotherapy, should be the focus of future studies. Of note, the effect of antibiotics on this complex scenario seems to deserve careful consideration.

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Author information

Authors and Affiliations

  1. Medicine and Surgery Department, University of Parma, Parma, Italy

    Melissa Bersanelli

  2. Medical Oncology Unit, University Hospital of Parma, Via Gramsci 14, 43126, Parma, Italy

    Melissa Bersanelli & Sebastiano Buti

  3. Medical Oncology Unit, Hospital of Macerata, Macerata, Italy

    Matteo Santoni

  4. Dipartimento Medico-Geriatrico-Riabilitativo, University Hospital of Parma, Parma, Italy

    Andrea Ticinesi

Authors
  1. Melissa Bersanelli
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  2. Matteo Santoni
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  3. Andrea Ticinesi
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  4. Sebastiano Buti
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Corresponding author

Correspondence to Melissa Bersanelli.

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Funding

No external funding was used in the preparation of this manuscript.

Conflict of interest

Melissa Bersanelli received honoraria for advisory roles and as speaker at scientific events from Bristol-Myers Squibb (BMS), Novartis, and Pfizer. Andrea Ticinesi received a congress grant from Novo Nordisk. Sebastiano Buti received honoraria for advisory roles and as speaker at scientific events from Pfizer, BMS, IPSEN, Pierre-Fabre, Merck Sharp & Dohme (MSD), and AstraZeneca. Matteo Santoni declares that he has no conflicts of interest that might be relevant to the contents of this manuscript.

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Bersanelli, M., Santoni, M., Ticinesi, A. et al. The Urinary Microbiome and Anticancer Immunotherapy: The Potentially Hidden Role of Unculturable Microbes. Targ Oncol 14, 247–252 (2019). https://doi.org/10.1007/s11523-019-00643-7

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  • DOI: https://doi.org/10.1007/s11523-019-00643-7

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