Abiraterone acetate preferentially enriches for the gut commensal Akkermansia muciniphila in castrate-resistant prostate cancer patients

Authors

Brendan A. Daisley, The University of Western Ontario
Ryan M. Chanyi, The University of Western Ontario
Kamilah Abdur-Rashid, The University of Western Ontario
Kait F. Al, The University of Western Ontario
Shaeley Gibbons, The University of Western Ontario
John A. Chmiel, The University of Western Ontario
Hannah Wilcox, The University of Western Ontario
Gregor Reid, The University of Western Ontario
Amanda Anderson, Schulich School of Medicine & Dentistry
Malcolm Dewar, Schulich School of Medicine & Dentistry
Shiva M. Nair, Schulich School of Medicine & Dentistry
Joseph Chin, Schulich School of Medicine & Dentistry
Jeremy P. Burton, The University of Western Ontario

Document Type

Article

Publication Date

12-1-2020

Journal

Nature Communications

Volume

11

Issue

1

URL with Digital Object Identifier

10.1038/s41467-020-18649-5

Abstract

Abiraterone acetate (AA) is an inhibitor of androgen biosynthesis, though this cannot fully explain its efficacy against androgen-independent prostate cancer. Here, we demonstrate that androgen deprivation therapy depletes androgen-utilizing Corynebacterium spp. in prostate cancer patients and that oral AA further enriches for the health-associated commensal, Akkermansia muciniphila. Functional inferencing elucidates a coinciding increase in bacterial biosynthesis of vitamin K2 (an inhibitor of androgen dependent and independent tumor growth). These results are highly reproducible in a host-free gut model, excluding the possibility of immune involvement. Further investigation reveals that AA is metabolized by bacteria in vitro and that breakdown components selectively impact growth. We conclude that A. muciniphila is a key regulator of AA-mediated restructuring of microbial communities, and that this species may affect treatment response in castrate-resistant cohorts. Ongoing initiatives aimed at modulating the colonic microbiota of cancer patients may consider targeted delivery of poorly absorbed selective bacterial growth agents.