Gut microbiota and dietary intervention: affecting immunotherapy efficacy in non–small cell lung cancer

Abstract

Non–small cell lung cancer (NSCLC) accounts for 80–85% of all lung cancers. In recent years, treatment with immune checkpoint inhibitors (ICIs) has gradually improved the survival rate of patients with NSCLC, especially those in the advanced stages. ICIs can block the tolerance pathways that are overexpressed by tumor cells and maintain the protective activity of immune system components against cancer cells. Emerging clinical evidence suggests that gut microbiota may modulate responses to ICIs treatment, possibly holding a key role in tumor immune surveillance and the efficacy of ICIs. Studies have also shown that diet can influence the abundance of gut microbiota in humans, therefore, dietary interventions and the adjustment of the gut microbiota is a novel and promising treatment strategy for adjunctive cancer therapy. This review comprehensively summarizes the effects of gut microbiota, antibiotics (ATBs), and dietary intervention on the efficacy of immunotherapy in NSCLC, with the aim of informing the development of novel strategies in NSCLC immunotherapy.

Repeating late-phase pseudo-progression in a patient with non-small cell lung cancer treated with long-term nivolumab monotherapy; a case report

“…Some previous reports suggest that host immune status and external factors such as COVID-19 vaccinations ( 7 ), corticosteroids ( 8 ), and antibiotics/probiotics ( 9 ) affect anti-cancer immune systems by stimulating or suppressing immune cells. It is well known that diet and lifestyle also affect immune status, these potentially influence the efficacy for ICI therapy ( 10 ).…”

Gut Microbiota Are a Novel Source of Biomarkers for Immunotherapy in Non-Small-Cell Lung Cancer (NSCLC)

“…Patients with a heterogenous gut microbiota composition at baseline have a better prognosis than those patients with a poor heterogeneous composition of microbiota [8]. It appears clear how all conditions modulating the gut microbiota, either with reduced variability or the elimination of good bacteria, can have a negative impact on the prognosis or treatment efficacy for LC patients, suggesting how relevant it is to learn how to modulate them [14].…”

“…The antibiotic exposure from 60 days before starting immunotherapy and 30 days after the last immunotherapy correlated with a poor prognosis and immunotherapy resistance [14]. Scarce information on the antibiotic type, antibiotic route, and the duration of therapy are available.…”