Department of Oncology, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, China; Jiangsu Collaborative Innovation Center of Traditional Chinese Medicine in Prevention and Treatment of Tumor, The First Clinical College of Nanjing University of Chinese Medicine, Nanjing, China.
College of Pharmacy, Nanjing University of Chinese Medicine, Nanjing, China.
Biomed Pharmacother. 2023 Sep;165:115040. doi: 10.1016/j.biopha.2023.115040. Epub 2023 Jun 24.
Colorectal cancer (CRC) is one of highly prevalent cancer. Immunotherapy with immune checkpoint inhibitors (ICIs) has dramatically changed the landscape of treatment for many advanced cancers, but CRC still exhibits suboptimal response to immunotherapy. The gut microbiota can affect both anti-tumor and pro-tumor immune responses, and further modulate the efficacy of cancer immunotherapy, particularly in the context of therapy with ICIs. Therefore, a deeper understanding of how the gut microbiota modulates immune responses is crucial to improve the outcomes of CRC patients receiving immunotherapy and to overcome resistance in nonresponders. The present review aims to describe the relationship between the gut microbiota, CRC, and antitumor immune responses, with a particular focus on key studies and recent findings on the effect of the gut microbiota on the antitumor immune activity. We also discuss the potential mechanisms by which the gut microbiota influences host antitumor immune responses as well as the prospective role of intestinal flora in CRC treatment. Furthermore, the therapeutic potential and limitations of different modulation strategies for the gut microbiota are also discussed. These insights may facilitate to better comprehend the interplay between the gut microbiota and the antitumor immune responses of CRC patients and provide new research pathways to enhance immunotherapy efficacy and expand the patient population that could be benefited by immunotherapy.
结直肠癌(CRC)是一种高发癌症。免疫检查点抑制剂(ICIs)的免疫疗法极大地改变了许多晚期癌症的治疗格局,但 CRC 对免疫疗法的反应仍然不理想。肠道微生物群可以影响抗肿瘤和促肿瘤免疫反应,并进一步调节癌症免疫疗法的疗效,特别是在使用 ICI 治疗的情况下。因此,更深入地了解肠道微生物群如何调节免疫反应对于改善接受免疫治疗的 CRC 患者的预后以及克服无应答者的耐药性至关重要。本综述旨在描述肠道微生物群、CRC 和抗肿瘤免疫反应之间的关系,特别关注肠道微生物群对抗肿瘤免疫活性影响的关键研究和最新发现。我们还讨论了肠道微生物群影响宿主抗肿瘤免疫反应的潜在机制以及肠道菌群在 CRC 治疗中的潜在作用。此外,还讨论了不同调节肠道微生物群策略的治疗潜力和局限性。这些见解可能有助于更好地理解 CRC 患者肠道微生物群与抗肿瘤免疫反应之间的相互作用,并为提高免疫治疗疗效和扩大免疫治疗受益人群提供新的研究途径。
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