Microbiota and cancer immunotherapy: Mechanisms, clinical implications, and precision therapeutics

Microbiome dysbiosis is implicated in immune-related adverse events (irAEs) associated with immune checkpoint inhibitors (ICIs).

• Microbial communities and their metabolites can regulate host immunity by activating dendritic cells and improving T-cell infiltration.
• The tumor microenvironment can be reprogrammed by microbiota interactions, potentially enhancing the effectiveness of cancer treatments.
• Precision microbiome interventions, such as fecal microbiota transplantation and engineered probiotics, may improve responsiveness to ICIs and reduce irAEs.
• Current findings are based on preclinical and early-phase clinical studies, highlighting a need for rigorous validation in multicenter trials.
• Combining microbiome profiling with individual patient characteristics could lead to personalized immunotherapy approaches.

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