Cancer pharmacomicrobiomics: targeting microbiota to optimise cancer therapy outcomes

Area of Science:

• Oncology
• Microbiology
• Pharmacology

Background:

• Novel cancer therapies like immune checkpoint inhibitors (ICIs) show promise but face challenges in resistance and toxicity.
• The gut microbiota's influence on cancer therapeutic efficacy and toxicity is increasingly recognized.
• Microbiota, unlike host genetics, are amenable to modification through interventions like fecal microbiota transplantation (FMT), probiotics, and antibiotics.

Purpose of the Study:

• To review mechanistic insights into gut microbial interactions with chemotherapy and ICIs.
• To explore the interplay between gut bacteria and the pharmacokinetics and pharmacodynamics of cancer treatments.
• To discuss the translational potential and limitations of microbiota modulation in cancer therapy.

Main Methods:

• Review of preclinical studies identifying mechanisms of microbial influence on cancer treatment.
• Analysis of clinical trials demonstrating the potential of microbiota modulation.
• Exploration of pharmacokinetic (metabolism, enzymatic degradation) and pharmacodynamic (immunomodulation) interactions.

Main Results:

• Gut microbes significantly impact cancer treatment efficacy and toxicity.
• Mechanisms involve microbial metabolism, enzymatic degradation, and immunomodulation affecting drug action.
• Microbiota modulation strategies like FMT, probiotics, and antibiotics show translational potential.

Conclusions:

• Understanding gut microbiota interactions is crucial for personalized cancer medicine.
• Manipulating gut microbiota offers a promising avenue to enhance cancer therapeutic responses.
• Further research is needed to overcome limitations in microbiota modulation for cancer patients.