针对肠道菌群的癌症治疗

SCI

31 Octember 2022

Targeting the gut microbiota for cancer therapy

(Nat Rev Cancer; IF：69.8)

Fernandes MR, Aggarwal P, Costa RGF et al. Targeting the gut microbiota for cancer therapy. Nat Rev Cancer 2022. DOI: 10.1038/s41568-022-00513-x

Correspondence to：trinchig@mail.nih.gov

Abstract 摘要

Growing evidence suggests that the gut microbiota modulates the efficacy and toxicity of cancer therapy, most notably immunotherapy and its immune- related adverse effects. The poor response to immunotherapy in patients treated with antibiotics supports this influential role of the microbiota. Until recently, results pertaining to the identification of the microbial species responsible for these effects were incongruent, and relatively few studies analysed the underlying mechanisms. A better understanding of the taxonomy of the species involved and of the mechanisms of action has since been achieved. Defined bacterial species have been shown to promote an improved response to immune- checkpoint inhibitors by producing different products or metabolites. However, a suppressive effect of Gram- negative bacteria may be dominant in some unresponsive patients. Machine learning approaches trained on the microbiota composition of patients can predict the ability of patients to respond to immunotherapy with some accuracy. Thus, interest in modulating the microbiota composition to improve patient responsiveness to therapy has been mounting. Clinical proof- of- concept studies have demonstrated that faecal microbiota transplantation or dietary interventions might be utilized clinically to improve the success rate of immunotherapy in patients with cancer. Here, we review recent advances and discuss emerging strategies for microbiota- based cancer therapies.

越来越多的证据表明，肠道菌群调节癌症治疗的疗效和毒性，最显著的是免疫治疗及其与免疫相关的不良反应。使用抗生素治疗的患者对免疫治疗的不良反应支持了微生物群的这一影响作用。直到最近，对这些影响相关的微生物种类的鉴定结果依然没有定论，分析其潜在机制的研究也相对较少。从那以后，人们对所涉种类的分类学和作用机制有了更好的了解。已证实的细菌种类可通过产生不同的产物或代谢物来改善对免疫检查点抑制剂的反应。然而，革兰氏阴性菌的抑制作用可能在一些无反应的患者中占主导地位。采用机器学习方法，针对患者的微生物群组成训练集，可以预测患者对免疫治疗的反应能力，并具有一定的准确性。因此，科研人员对于调节菌群组成以提高患者对治疗的反应性的兴趣一直在增加。研究表明，粪便菌群移植或膳食干预可用于临床提高癌症患者免疫治疗的成功率。在这里，我们回顾了最近的进展，并讨论了基于微生物群的癌症治疗的新兴策略。