Department of Melanoma Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
Department of Epidemiology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
Lancet Oncol. 2019 Feb;20(2):e77-e91. doi: 10.1016/S1470-2045(18)30952-5.
Although novel therapies, including immunotherapy, have dramatically improved outcomes for many patients with cancer, overall outcomes are heterogeneous and existing biomarkers do not reliably predict response. To date, predictors of response to cancer therapy have largely focused on tumour-intrinsic features; however, there is growing evidence that other host factors (eg, host genomics and the microbiome) can substantially affect therapeutic response. The microbiome, which refers to microbiota within a host and their collective genomes, is becoming increasingly recognised for its influence on host immunity, as well as therapeutic responses to cancer treatment. Importantly, microbiota can be modified via several different strategies, affording new angles in cancer treatment to improve outcomes. In this Review, we examine the evidence on the role of the microbiome in cancer and therapeutic response, factors that influence and shape host microbiota, strategies to modulate the microbiome, and present key unanswered questions to be addressed in ongoing and future research.
尽管包括免疫疗法在内的新疗法显著改善了许多癌症患者的预后，但总体预后存在异质性，且现有生物标志物不能可靠地预测疗效。迄今为止，癌症治疗反应的预测因子主要集中在肿瘤内在特征上；然而，越来越多的证据表明，其他宿主因素（例如，宿主基因组学和微生物组）可以显著影响治疗反应。微生物组是指宿主内的微生物群及其集体基因组，它对宿主免疫以及癌症治疗的治疗反应的影响正日益受到关注。重要的是，微生物组可以通过几种不同的策略进行修饰，为改善治疗效果提供了癌症治疗的新角度。在这篇综述中，我们研究了微生物组在癌症和治疗反应中的作用、影响和塑造宿主微生物组的因素、调节微生物组的策略，并提出了当前和未来研究中需要解决的关键未决问题。
