The emerging tumor microbe microenvironment: From delineation to multidisciplinary approach-based interventions

Complications and comorbidities associated with antineoplastic chemotherapy: Rethinking drug design and delivery for anticancer therapy

“…In addition to immune compromise and related comorbidities, cancer therapy-associated factors including chemotherapy are among the risk factors for infections in cancer patients. Despite procedures and devices used in the prognostic process, the emergence of neutropenia, disruption of anatomic barriers, and obstruction of healthy passages can considerably increase the infectious risk in patients with solid tumors 91 . Infections often occur in body sites hinging on the tumor sites, especially those locations enriched with epithelial and mucosal structures where microorganisms dwell, for example, skin, bloodstream, respiratory tract, and urinary tract 91 .…”

“…, alkylating agents, antimetabolic agents, anticancer antibiotics, platinum complexes, and alkaloids) enable to induce neutropenia, highlighting the need for more cautious management of elderly and underweight patients receiving chemotherapy 96 . Damage to and disruption of natural anatomic barriers, for instance, the skin and mucosal surfaces, is another common side effect of chemotherapy, facilitating the invasion of infective pathogens and the development of infectious complications 91 Anthracyclines, 5-FU, cisplatin, carboplatin, etoposide, cyclophosphamide, ifosfamide, methotrexate, vinblastine, and taxanes are among the common chemotherapeutic agents that frequently cause mucositis 97 . Furthermore, the injury to mucosal barriers is frequently associated with a changed host microbiome, thus detrimental dysbiosis and even antimicrobial resistance 92 , 98 , 99 .…”

“…Furthermore, the injury to mucosal barriers is frequently associated with a changed host microbiome, thus detrimental dysbiosis and even antimicrobial resistance 92 , 98 , 99 . Additionally, antimicrobial prophylaxis, usually against Gram-negative organisms, is commonly given to patients with hematologic malignancies instead of those with solid tumors, leading to a higher prevalence of Gram-negative infections in these patients 91 . Fortunately, the prevention and control of infectious complications in cancer patients has garnered the attention of both oncologists and clinicians, and corresponding guidelines and practice advice have been set up to tackle infectious issues 100 , 101 .…”