Targeting the Gut Microbiome in Cancer Treatment

Abstract

The gut microbiome shapes the host immune system, enhances intestinal homeostasis and mucosal barrier integrity, imparts a crucial role in host metabolism, and protects against pathogens. Mounting evidence uncovered significant associations of the altered gut microbiota community with several types of malignancies, particularly in gastrointestinal cancers. Exploring the role of microbiota, microbial genes, and corresponding pathways in cancer development and treatment represents the main challenge of microbiome research in the era of precision medicine. Anti-cancer and supportive treatments, as well as antibiotic prophylaxis, significantly affect the composition of the gut microbiome in cancer patients, leading to acute dysbiosis and severe gastrointestinal complications. Recent studies widely documented the role of the gut and intratumoral bacteria in modulating responses to anti-cancer therapies and treatment-related side effects. In addition, some data link the changes in microbial diversity to the late effects of treatment in cancer survivors. Microbiota modulations by probiotics and fecal microbiota transplantation represent an emerging trend in cancer patient care, aiming to increase bacterial diversity, alleviate treatment-related acute and long-term toxicity, and improve the response to various types of cancer treatment modalities. Importantly, uncovering the complex associations between patient microbiota and disease may identify the microbial prognostic and predictive biomarkers and open up the possibilities for individual approaches to improve the clinical outcomes for cancer patients.KeywordsGut microbiomeTumor microbiomeCancer treatmentMicrobiota modulationsProbioticsFecal microbiota transplantation