The gut microbiome is known to influence cancer development and progression, but now research is pointing toward an additional “role in defining the efficacy and toxicity of chemotherapeutic agents (5-fluorouracil, CTX, Irinotecan, Oxaliplatin, Gemcitabine, Methotrexate) and immunotherapeutic (anti-PD-L1/ anti-PD-1 and anti-CTLA-4) compounds,” write authors of a basics review article. “This evidence is supported in numerous in-vitro, animal, and clinical studies which highlight the importance of microbial mechanisms in defining therapeutic responses.”
The article outlines the current knowledge on oncological pharmacomicrobiomics and describes how the gut microbiome can influence treatment response across cancer types. “If the microbiome is to be successfully translated into next-generation oncological treatments, a new multimodal model of the oncomicrobiome must be conceptualized which incorporates gut microbial co-metabolism of pharmacological agents into cancer care,” write the authors.
Since most interventional studies have been conducted using animal models, the authors point to the need for clinical evidence of the interactions between microbiomes and pharmacologic agents. “Large-scale human-centered studies are required to translate those results in a clinical setting,” the authors conclude. “Future studies are needed to obtain a better understanding of the underlying microbiome–drug interactions and identify microbiome-derived biomarkers with a goal of designing strategies to improve therapy outcomes through modulation of the gut microbiome.”