Role of the gut microbiota in anticancer therapy: from molecular mechanisms to clinical applications

Abstract

In the past period, due to the rapid development of next-generation sequencing technology, accumulating evidence has clarified the complex role of the human microbiota in the development of cancer and the therapeutic response. More importantly, available evidence seems to indicate that modulating the composition of the gut microbiota to improve the efficacy of anti-cancer drugs may be feasible. However, intricate complexities exist, and a deep and comprehensive understanding of how the human microbiota interacts with cancer is critical to realize its full potential in cancer treatment. The purpose of this review is to summarize the initial clues on molecular mechanisms regarding the mutual effects between the gut microbiota and cancer development, and to highlight the relationship between gut microbes and the efficacy of immunotherapy, chemotherapy, radiation therapy and cancer surgery, which may provide insights into the formulation of individualized therapeutic strategies for cancer management. In addition, the current and emerging microbial interventions for cancer therapy as well as their clinical applications are summarized. Although many challenges remain for now, the great importance and full potential of the gut microbiota cannot be overstated for the development of individualized anti-cancer strategies, and it is necessary to explore a holistic approach that incorporates microbial modulation therapy in cancer.

Biomimetic piezoelectric nanomaterial-modified oral microrobots for targeted catalytic and immunotherapy of colorectal cancer

“…CRC is characterized by a highly inflammatory environment and disruption of the intestinal barrier, which may facilitate the entry of certain microorganisms and promote the colonization of other microorganisms within the tumor. Various factors can lead to the breakdown of the mucosal barrier, allowing microorganisms to infiltrate the tumor ( 50 ). In this study, the recruitment of SAM to the CRC environment allowed the microrobots to successfully reach the cancer site.…”

Cell fate regulation governed by p53: Friends or reversible foes in cancer therapy

“…type III secretion system (T3SS) of Salmonella enterica can bind the effector protein AvrA and cyclomodulin‐like protein typhoid toxin, promoting tumorigenesis genetically and epigenetically, through genotoxin‐mediated mutagenesis [365]. Specifically, AvrA promotes cell proliferation and differentiation and inhibits cell cycle arrest via the JAK/STAT, Wnt/ β‐catenin or acetyltransferase‐targeted p53 pathway, collectively resulting in tumorigenesis [366, 367]. To sum up, cancer‐promoting bacteria may participate in the process of oncogenesis through a variety of different molecular pathways, and several main mechanisms are summarized here (Figure 8).…”

Exploring the human microbiome – A step forward for precision medicine in breast cancer

“…Studies have shown that the gut microbiota can modulate cancer treatments' efficacy and adverse effects, and that cancer and anticancer therapies interact bidirectionally with the gut microbiota 134 . In addition, certain gut microbes have been found to protect against inappropriate inflammation and modulate the immune response, which is particularly relevant to breast cancer immunotherapy 135 . Clinical and preclinical studies have demonstrated that the gut microbiota strongly influences tumor response to immune checkpoint blockade, with follow‐up studies showing an enhancement of the T cell response via the activation of antigen presenting cells, such as dendritic cells, in mice models with a stable healthy gut microbiome 89,136 .…”