Targeting microbiota to optimise cancer therapy outcomes

The human microbiota is a dynamic community of 40 trillion microbes, including 3000 species of bacteria, fungi, and viruses.

They live primarily in the gastrointestinal tract (Gut).

The gut microbiota controls many physiological functions, including nutritional responses and intestinal and immune system homeostasis.

Dysbiosis, or a change in the composition of the microbiota as a result of disrupted homeostasis, has been linked to GI (acidity, IBS, etc.), neurological (learning disabilities, autism, etc.), and metabolic disorders (diabetes, hypertension, etc.).

Specific gut microbes have also been linked to cancer pathogenesis.

While these bacteria have direct effects on tumorigenesis, some microbes promote inflammation or weaken immunosurveillance, allowing cancer to develop indirectly.

These microbial immunomodulatory activities are referred to as the ‘immune-oncology-microbiome axis’.

Aside from pathogenesis, the gut microbiota influences cancer treatment responses.

A growing body of evidence suggests that gut microbiota plays a role in determining cancer therapeutic efficacy and toxicity.

Clinical trials have shown that microbiota modulation can help with cancer treatment.

Gut microbial interactions with chemotherapy and immune checkpoint inhibitors result in favorable outcomes in cancer patients via interactions between gut bacteria and pharmacokinetics (eg, metabolism, enzymatic degradation) or pharmacodynamics (eg, immunomodulation). Read the full study in the journal Gut published in July 2022.

Key findings of this research article:

• Emerging evidence points to the importance of gut microbiota in cancer treatment outcomes, particularly in chemotherapy and immunotherapy.
• The gut microbiota interacts with cancer drugs in a variety of ways, including pharmacokinetics (e.g., metabolism, enzymatic degradation) and pharmacodynamics (eg, immunomodulation).
• Meanwhile, cancer therapy can change the composition of the microbiota, resulting in bidirectional interactions.
• The gut microbiota has the potential to be a predictive biomarker for cancer treatment responses, which could help guide treatment selection.
• Probiotics, prebiotics, and dietary modification have all shown promise in improving cancer treatment outcomes.
• When compared to host genetics, the gut microbiota is more easily modifiable and is expected to play a critical role in next-generation personalized medicine.