Harnessing the Gut Microbiome in Cancer Immunotherapy: Mechanisms, Challenges, and Routes to Personalized Medicine—A Systematic Review
Abstract
Introduction Immunotherapy approaches have improved by Immune check point inhibitors such as PD-1, CTLA-4, and PD-L1 inhibitors. However, the response to immunotherapy varies widely among patients due to various factors. Co-administration of probiotics with ICIs has become a promising strategy to improve therapeutic outcomes. This review evaluates the impact of environmental factors and life style on cancer pathophysiology, outcome of disease, and response to the treatment. It evaluates the role of probiotics in modulating immune responses and the synergistic interaction of probiotics with immunotherapy. Methods We conducted a comprehensive systematic review of clinical and preclinical studies to assess the effects of probiotics on immunotherapy outcomes. Studies were selected based on their focus on probiotics’ role in immune response modulation and interaction with ICIs. Data from trials involving patients with varying responses to immunotherapy, including those with prior resistance, were analyzed to explore the probiotic-enhanced immunotherapy. Results Gut microbiome has wide effects on immune responses through different pathways like production of short chain fatty acids (SCFAs), polysaccharide A, and indole-3-carbaldehyde. Also, probiotics found to enhance Anit-inflammatory responses and increase CD8+ T-cell activity, suggesting a synergistic effect with ICIs. Gut microbiota composition plays a key role in determining the effectiveness of immunotherapy, especially in…
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