The Clinical Link between Human Intestinal Microbiota and Systemic Cancer Therapy

Abstract

Clinical interest in the human intestinal microbiota has increased considerably. However, an overview of clinical studies investigating the link between the human intestinal microbiota and systemic cancer therapy is lacking. This systematic review summarizes all clinical studies describing the association between baseline intestinal microbiota and systemic cancer therapy outcome as well as therapy-related changes in intestinal microbiota composition. A systematic literature search was performed and provided 23 articles. There were strong indications for a close association between the intestinal microbiota and outcome of immunotherapy. Furthermore, the development of chemotherapy-induced infectious complications seemed to be associated with the baseline microbiota profile. Both chemotherapy and immunotherapy induced drastic changes in gut microbiota composition with possible consequences for treatment efficacy. Evidence in the field of hormonal therapy was very limited. Large heterogeneity concerning study design, study population, and methods used for analysis limited comparability and generalization of results. For the future, longitudinal studies investigating the predictive ability of baseline intestinal microbiota concerning treatment outcome and complications as well as the potential use of microbiota-modulating strategies in cancer patients are required. More knowledge in this field is likely to be of clinical benefit since modulation of the microbiota might support cancer therapy in the future.

Gut Microbiota Profiling in Patients With HER2-Negative Metastatic Breast Cancer Receiving Metronomic Chemotherapy of Capecitabine Compared to Those Under Conventional Dosage

“…Many pharmaceutical agents influence the composition of intestinal microbiota, while gut microorganisms may modulate the efficacy and the toxicity of drugs as well (17,26). In our study, both univariate and multivariate analyses showing significantly positive and negative predictive correlation with PFS were observed in s_Blautia obeum and Slackia relatively in the treatment of capecitabine for metastatic breast cancer patients.…”

“…As for breast cancer, several previous studies investigated the association between gut microbiota and the development and the dissemination of breast cancer via regulation of inflammation, immunity, and metabolism ( 23 – 26 ). However, there was scarcely any evidence on the composition of gut microbiota in HER2-negative metastatic breast cancer patients who receive different dosage regimens of chemotherapy.…”

Fecal Microbiota Transplantation Prevents Intestinal Injury, Upregulation of Toll-Like Receptors, and 5-Fluorouracil/Oxaliplatin-Induced Toxicity in Colorectal Cancer

“…The microbiota formed by microorganisms and residing in the gastrointestinal tract is referred to as "intestinal microbiota" or "gut microbiota" [1,2]. The microbiota affects various aspects of human health, including providing nutrients and vitamins, protecting against pathogens, epithelial mucosa homeostasis, and immune system development [3].…”

“…The microbiota affects various aspects of human health, including providing nutrients and vitamins, protecting against pathogens, epithelial mucosa homeostasis, and immune system development [3]. Microbial dysbiosis has been linked to various metabolic and inflammatory diseases, such as diabetes mellitus, hypertension, inflammatory bowel disease, and obesity [1,2]. Growing evidence not only implies that chemotherapeutics affect the intestinal microbial composition but also that multidirectional interactions between the gut microbiota and the host immune system may influence development and progression of chemotherapy-induced intestinal inflammation [4][5][6].…”

Microbiota from alginate oligosaccharide-dosed mice successfully mitigated small intestinal mucositis

“…Gut microbiota is reported to influence many aspects of our health because it provides nutrients and vitamins, fights against pathogens, maintains homeostasis of the epithelial mucosa, and supports the body’s immune system [ 24 ]. On the other hand, microbiota dysbiosis has been shown to lead to various diseases [ 25 , 26 ] such as diabetes, hypertension, IBD (inflammatory bowel disease), obesity, polycystic ovary syndrome (PCOS) [ 27 ], and disruption of spermatogenesis [ 28 ]. FMT is the last chance treatment for Clostridium difficile infections [ 25 , 26 ], and it also has been applied in many disease models and clinical trials with a very high cure rate and few adverse effects [ 29 , 30 ].…”