Emerging Evidence of the Gut Microbiome in Chemotherapy: A Clinical Review

Abstract

Increasing evidence suggests that the gut microbiome is associated with both cancer chemotherapy (CTX) outcomes and adverse events (AEs). This review examines the relationship between the gut microbiome and CTX as well as the impact of CTX on the gut microbiome. A literature search was conducted in electronic databases Medline, PubMed and ScienceDirect, with searches for “cancer” and “chemotherapy” and “microbiome/microbiota”. The relevant literature was selected for use in this article. Seventeen studies were selected on participants with colorectal cancer (CRC; n=5), Acute Myeloid Leukemia (AML; n=3), Non-Hodgkin’s lymphoma (n=2), breast cancer (BCa; n=1), lung cancer (n=1), ovarian cancer (n=1), liver cancer (n=1), and various other types of cancers (n=3). Seven studies assessed the relationship between the gut microbiome and CTX with faecal samples collected prior to (n=3) and following CTX (n=4) showing that the gut microbiome is associated with both CTX efficacy and toxicity. Ten other prospective studies assessed the impact of CTX during treatment and found that CTX modulates the gut microbiome of people with cancer and that dysbiosis induced by the CTX is related to AEs. CTX adversely impacts the gut microbiome, inducing dysbiosis and is associated with CTX outcomes and AEs. Current evidence provides insights into the gut microbiome for clinicians, cancer survivors and the general public. More research is required to better understand and modify the impact of CTX on the gut microbiome.

The gut microbiome, immune check point inhibition and immune-related adverse events in non-small cell lung cancer

“…This in turn stimulates production of antitumor T lymphocytes [28,29] via mechanisms such as molecular mimicry. Further clinical studies have confirmed the interaction between chemotherapy and the GM, with a favourable GM at baseline leading to superior outcomes in multiple tumour types [30], including lung cancer [31]. On the other hand, chemotherapy can induce dysbiosis, which is associated with higher rates of adverse events [30].…”

Natural Inhibitors of P-glycoprotein in Acute Myeloid Leukemia

“…The list of therapeutic properties is certainly very long for curcumin and lupeol, whose anti-inflammatory, antioxidant, antimicrobial, antitumor, cardioprotective, antipyretic, analgesic, wound healing, anticonvulsant, antiarthritic, and antidiabetic activities are well known [ 54 , 55 , 56 , 57 ], whereas for phytol and heptacosane, the knowledge of those is limited. Furthermore, it is known that the dysfunction of the intestinal microbiome is associated with both the outcome of chemotherapy and adverse events, in many types of neoplastic tumors as well as in AML [ 58 , 59 ]. Many natural compounds are able to modify the response to therapy by modulating the microbiota [ 60 , 61 , 62 ].…”

Gut microbiome and neurosurgery: Implications for treatment

“…159 Recently, the implication of the gut microbiome in cancer response to therapy became an area of research interest in the field of immunooncology and is being investigated as a possible tool to enhance therapeutic efficacy. [168][169][170]…”

“…Multiple factors have been demonstrated to significantly influence the results of such therapy ranging from modifiable ones, such as lifestyle, to non‐modifiable ones, such as genetic inheritance 159 . Recently, the implication of the gut microbiome in cancer response to therapy became an area of research interest in the field of immuno‐oncology and is being investigated as a possible tool to enhance therapeutic efficacy 168–170 …”